急性出血性脑卒中早期预后的影响因素

A study of risk factors of early prognosis on patients with acute intracerebral hemorrhage

目的 :探讨急性出血性脑卒中(intracerebral hemorrhage,ICH)早期预后的影响因素,为临床治疗决策提供理论依据。方法:收集急性ICH患者666例,随访观察21 d时的临床转归情况,采用单因素和多因素Logistic回归分析急性ICH患者入院时的临床指标及主要治疗方案与早期预后之间的关系。结果:多因素Logistic回归分析显示,发病至入院时间<6 h(P=0.003)、入院时患有高血压(P=0.024)、高血糖(P=0.030)、合并肺部感染(P=0.035)及发热(P=0.003)、中风病类诊断评分分级(P<0.001)、出血部位(P=0.032)均是ICH早期预后不良的独立危险因素;而中西医治疗(P=0.001)则是ICH早期预后良好的保护性因素。结论:综合预后有关的多个影响因素作为预测急性ICH早期预后的指标,有利于实施个体化临床决策,以降低病死率和提高患者生存质量。

Objective：To investigate the risk factors of acute intracerebral hemorrhage （ICH） early prognosis and provide a theoretical basis for clinical treatment. Methods：A total of 666 patients with ICH were collected and followed up the clinical outcomes for 21 days. Monovariant and multivariant logistic regression were performed to analyze the relationship between indicators, major treatment options of patients on admission and early prognosis. Results：Logistic regression analysis found that onset to admission time 〈6 hours （P = 0.003） ,suffering from high blood pressure on admission （P = 0.024）,high blood glucose （P = 0.030）, pulmonary infection （P = 0.035） and fever （P = 0.003）,diagnostic score classification of stroke （P 〈 0.001） and bleeding sites （P = 0.032） were the risk factors in poor prognosis of ICH;the therapeutic plan of the combination of tradition Chinese and western medicine was the protective factor for ICH. Conclusion：The predictor of early prognosis by integrating multiple risk factors associated with acute ICH was beneficial for the implementation of individual clinical decision to reduce patients＂ mortality and raise their quality of life.