影响脑出血患者心肌酶学变化的因素分析

Analyses of some factors for myocardial enzyme changes in patients with cerebral hemorrhage

目的探讨影响脑出血患者心肌酶学变化的相关因素。方法将125例急性自发性脑出血患者分别按其出血量、出血部位、Glasgow评分进行分组,与50例健康体检者进行比较,观察各组患者心肌酶学急性期变化情况。并动态监测心肌酶学改变,了解酶学变化趋势。结果与健康对照组相比,出血量<20 mL、Glasgow评分>12分患者心肌酶学在急性期无明显改变(P>0.05);出血量>20 mL、Glasgow评分<12分患者心肌酶学急性期明显高于对照组(P<0.05);心肌酶学改变与出血部位有关,丘脑出血心肌酶改变最为显著;脑出血患者心肌酶高峰期在72 h,14 d基本恢复正常。结论脑出血患者心肌酶学变化与出血量、出血部位及病情严重程度密切相关,可将其作为监测病情变化和判断预后的有效指标。

Objective To investigate the related risk factors of myocardial enzyme changes in patients with cerebral hemorrhage. Methods 125 patients with acute cerebral hemorrhage, according to the amount of bleeding, the bleeding site and Glasgow score were studied retrospectively, all patients were divided into corresponding groups, compared with 50 health physical examination cases, the changes of myocardial enzyme in acute stage were observed. Meanwhile myocardial enzyme changes were monitored to acquaint the enzyme change trend. Results Compared with healthy control group, the patients‘amount of bleeding in the experimental group was less than 20 mL, Glasgow score was more than 12, which had not a signiifcant difference in myocardial enzyme （P〉0.05）, the patient’s amount of bleeding was more than 20 mL, Glasgow score less than 12 , which had a significant difference in myocardial enzyme （P〈0.05）, Myocardial enzyme changes were associated with the bleeding site. Thalamic hemorrhage had the most significant changes in myocardial enzymes. Myocardial enzyme reached peak at 72 hours in the patients with cerebral hemorrhage,14 days returned to normal level. Conclusion The changes of myocardial enzyme in patients with cerebral hemorrhage is closely related with the amount of bleeding, the bleeding site and the severity of the disease, which can be used as an effective indictor to monitor disease progression and prognosis.