铁蛋白在高血压脑出血后血肿周围脑水肿中的作用及机制研究

The study of the effectand mechanism of serum ferritin on perihematomal edema in patients with hypertensive intracerebral hemorrhage

目的探讨血清铁蛋白与高血压脑出血后血肿周围脑水肿的关系,并分析其在血肿周围脑水肿发生中的作用。方法采集2012-05—2013-11于我院住院治疗的38例高血压脑出血患者的临床资料和实验室数据,所有患者均在入院时及入院3-4d后行血清铁蛋白及头颅CT检查,计算入院时及入院3-4d后血肿体积、脑水肿总体积及经校正后的相对水肿体积,采用Spearman相关分析相对血肿周围脑水肿体积与血清铁蛋白的关系。结果与入院当天比较,入院第3-4天后血肿体积增加19%,但差异无统计学意义（P〉0.05）;脑水肿体积增大71%,差异有统计学意义（P〈0.05）。血肿周围脑水肿体积与血肿体积的比值即相对水肿体积增加1.13倍。入院当天,患者血清铁蛋白水平和相对水肿大小间无明显相关性（P〉0.05）;入院后第3-4天时相对水肿体积与血清铁蛋白呈正相关（r=0.67,P=0.006）。结论血清铁蛋白是反映高血压脑出血后血肿周围脑水肿程度的一个重要指标,其在血肿周围继发性脑水肿的发生中起重要作用。

Objective To explore the association between serum ferritin and perihematomal edema for the patients with hypertensive intracerebral hemorrhage and to analyze its role in the development of perihematomal edema.Methods Clinical data and laboratory data of 38 patients with hypertensive cerebral hemorrhage were collected in our hospital from May 2012 to November 2013.All patients were given the serum ferritin test and cranial CT examination on admission and 3-4days after admission.The hematoma volume,edema volume,relative perihematomal edema volume on admission and on the third day of admission were calculated,and then we analyzed the relationship between serum ferritin level and relative perihematomal edema volume by Spearman correlation analysis.Results Compared with the day of on admission,hematoma volume on the third or fourth day of admission increased by 19%,but the difference was not statistically significant（P〈0.05）;cerebral edema volume rose by 71% with the significant difference（P〈0.05）.The relative edema volume increased by 1.13 times.There was a significant positive correlation between serum ferritin and relative Perihematomal edema volume on the third or forth day（r=0.67,P=0.006）,but no significant correlation was found on admission（P〈0.05）.Conclusion Serum ferritin is an important indicator for perihematomal edema in patients with hypertensive intracerebral hemorrhage,which plays an important role in the occurrence of secondary perihematoma edema.