血红蛋白浓度与动脉瘤性蛛网膜下腔出血术后症状性脑血管痉挛的相关研究

An association study between hemoglobin concentration and symptomatic cerebral vasospasm of aneurismal subarachnoid hemorrhage after surgical treatment

目的探讨血液中血红蛋白浓度对动脉瘤性蛛网膜下腔出血（aneurysmal subarachnoid hemorrhage，aSAH）患者术后症状性脑血管痉挛发生的影响。方法回顾性分析218例动脉瘤破裂后行手术治疗患者的病例资料，先对可能影响症状性脑血管痉挛的因素进行单因素分析，再将单因素分析有统计学意义的因素纳入多因素Logistic回归分析。结果单因素分析提示血红蛋白浓度与患者术后症状性脑血管痉挛显著相关（P=0．0023）。多因素分析提示在调整了入院时Hunt—Hess分级、CTFisher分级混杂作用后，血红蛋白浓度与患者术后症状性脑血管痉挛显著相关，平均血红蛋白浓度在110～120g／L患者术后症状性脑血管痉挛发生率最低（P〈0．01）。结论血红蛋白浓度是动脉瘤性蛛网膜下腔出血患者术后症状性脑血管痉挛的一个独立危险因素，维持血红蛋白浓度在一定水平有利于减少患者术后症状性脑血管痉挛的发生。

Objective To investigate the association of the hemoglobin concentration in the blood with the symptomatic cerebral vasospasm in aneurysmal subarachnoid hemorrhage （SAH） patients after surgical treatment. Methods A retrospective study of medical data was conducted in 218 SAH cases receiving surgical treatment after aneurysm ruptured using single factor analysis and multiple factors logistic regression analysis. Results The single factor analysis revealed that hemoglobin concentration was significantly associated with symptomatic cerebral vasospasm in aneurysmal SAH patients after surgical treatment （P=0.0023）. After adjustment for hunthess grading on admission and CTfisher hierarchical hybrid effect, the multi-factor analysis revealed that hemoglobin concentration was significantly associated with symptomatic cerebral vasospasm in aneurysmal SAH patients after surgical treatment. Patients with average haemoglobin concentration at 110-120g/L after operation had the lowest incidence of symptomatic cerebral vasospasm （P〈0.01）. Conclusions Hemoglobin concentration is an independent risk factor of symptomatic cerebral vasospasm in patients with aneurysmal SAH after surgical treatment. Maintaining hemoglobin concentration at a certain level can reduce the occurrence of symptomatic cerebral vasospasm in patients with aneurysmal SAH after surgical treatment.