血清LDL-C水平对老年男性高血压性脑出血血肿扩大的预测作用

Clinic application of serum low-density lipoprotein cholesterol level in predicting expansion hematoma in elderly male patients with acute hypertensive intracerebral hemorrhage

目的探讨血清低密度脂蛋白胆固醇(LDL-C)水平对老年男性高血压性脑出血急性期血肿扩大有无预测作用。方法收集我院2012年6月—2014年5月发病6 h以内的老年男性高血压性脑出血患者108例,按发病时LDL-C水平分为LDL-C<2.49 mmol/L组和LDL-C≥2.49 mmol/L组,对2组患者入院时的收缩压(SBP)、舒张压(DBP)、血糖水平、凝血酶原时间(PT)、部分活化凝血酶时间(APTT)、纤维蛋白原(FIB)、血小板计数、血肿体积进行对比分析,并于发病24 h复查头CT了解2组血肿扩大情况并进行比较。应用Logistic回归模型,寻找对脑出血血肿扩大有预测价值的危险因素。结果 2组患者入院时SBP、DBP、血糖水平、PT、APTT、FIB、PLT、血肿体积比较差异无统计学意义;LDL-C<2.49 mmol/L组的血肿扩大发生率高于LDL-C≥2.49 mmol/L组(34.21%vs 11.43%,P<0.05)。Logistic多元回归分析显示,LDL-C<2.49 mmol/L是血肿扩大的危险因素。结论老年男性急性期高血压性脑出血患者LDL-C<2.49 mmol/L时提示血肿扩大风险较高,应及早采取相关治疗措施。

Objective To investigate whether serum level of low-density lipoprotein cholesterol can predict the expan-sion of hemorrhage growth in elderly male patients with acute hypertensive intracerebral hemorrhage. Methods Patients（n=108） who visited our hospital with from June 2012 until May 2014 spontaneous hypertensive intracerebral hemorrhage with-in 6 hours of onset which is confirmed by initial computed tomography（CT） were sent to repeated CT within 24 hours of on-set. All selected patients were divided into the LDL-C≥2.49 mmol/L group and LDL-C〈2.49 mmol/L group. Clinical dataof these 2 groups were compared and the relationships of hematoma growth and its risk factors were analyzed. Results Baseline blood pressure, the level of blood glucose, PT, APTT, FIB, PLT and hemorrhage volume did not differ significantlybetween the LDL-C≥2.49 mmol/L group and LDL-C〈2.49 mmol/L group. The ratio of hemorrhage growth in LDL-C2.49mmol/L group was significantly higher than that in LDL-C≥2.49 mmol/L group（34.21% vs 11.43%）. Multiple logistic regres-sion analysis showed that LDL-C〈2.49 mmol/L was the only risk factor contribute to hemorrhage growth. Conclusion Pa-tients with LDL-C〈2.49 mmol/L in acute intracerebral hemorrhage are of high risk of hemorrhage growth so early attentionand appropriate procedure are needed to prevent or slow its growth.