脑出血患者全身炎症反应综合征的临床研究

CLINICAL RESEARCH OF SIRS IN PATIENTS WITH CEREBRAL HEMORRHAGE

目的:探讨急性脑出血患者全身炎症反应综合征(SIRS)的发生率及其发生的相关因素,探讨SIRS在判断急性脑出血的病情和预后的临床价值。方法:对148例急性脑出血患者的临床资料、SIRS、多器官功能障碍综合征(MODS)发生情况进行分析。结果:急性脑出血后SIRS的发生率为41.89%,MODS的发生率为29.05%,且发生MODS的43例全部来源于急性脑出血诱发SIRS的患者;出血量≥30mL、出血破入脑室、随机血糖≥11.1mmol/L患者的SIRS发生率分别较出血量<30ml、出血未破入脑室、随机血糖<11.1mmol/L患者显著增高;SIRS发生率与脑出血病情和预后密切相关。结论:急性脑出血后SIRS的发生率高,是MODS发病的基础;SIRS发生与脑出血患者出血量、出血是否破入脑室、血糖的高低有着密切的关系;SIRS对于脑出血患者病情、预后判断具有重要价值。

Objective：To study the incidence of systemic inflammatory response syndrome （SIRS） in acute intracerebral hemorrhage （AICH） and the possible factors which might cause SIRS,and to explore the clinical value of SIRS in judging the state of illness and prognosis.Methods：Clinical data, the occurrence of SIRS and multiple organ dysfunction syndrome （MODS） of 148 patients with AICH were retrospectively studied.Results：The incidence of SIRS in AICH was 41.89%. The incidence of MODS in AICH was 29.05%. The incidence of SIRS of AICH patients with hemorrhage volume ≥ 30 ml, hemorrhage breaking into ventricles of brain, random blood glucose ≥ 11.1 mmol/L was obviously higher than that of the AICH patients with hemorrhage volume 〈30 ml , hemorrhage didn＇t break into ventricles of brains , random blood glucose 〈11.1mmol/L. The increasing incidence of SIRS was related to the disease severity and prognosis of AICH. Conclusions：The incidence of SIRS is high and could be the pathological basis of MODS after AICH. The incidence of SIRS is related to the hemorrhage volume, hemorrhage bre king into ventricles of brain ,and blood glucose levels of AICH. The SIRS is very useful in juging disease severity and prognosis of AICH.