脑出血患者入院时血糖、血压、心肌酶、D-二聚体与疾病严重程度及预后的关系研究

The study of relationship between .blood glucose, blood pressure, myocardial enzyme and D-dimer with disease severity and prognosis in patients with intracerebral hemorrhage

目的探讨脑出血患者人院时血糖（blood glucose，Glu）、血压（mean arterial blood pressure，MAP）、心肌酶以及D-二聚体（D—dimer）四项指标值与患者病情严重程度、血肿扩大、病死率及短期预后之间的关系。方法以Glu11．1mmol／L、MAP130mmHg、心肌酶谱四个指标是否升高以及D—dimer2．0mg／L对85例脑出血患者进行分层，分析四项指标与oICH评分、NIHSS评分、血肿扩大、30d死亡以及mRS评分之间的关系。结果85例患者中，Glu〉11．1mmol／L、MAP≥130mmHg、心肌酶升高、D—dimer≥2．0mg／L患者入院时平均oICH评分均在2分以上，NIHSS评分也均明显较高，和Glu≤11．1mmol／L、MAP〈130mmHg、心肌酶未升高、D—dimer〈2．0mg／L的患者比较差异均有统计学意义（P〈0．05）。Glu〉11．1mmol／L、MAP≥130mmHg、心肌酶升高以及D—dimer≥2．0mg／L的患者病死率以及mRS评分〉2分者比例明显较高（P〈0．05），是死亡以及预后不良的危险因素；Glu〉11．1mmol]L、MAP≥130mmHg以及D—dimer≥0mg／L也是血肿扩大的危险因素。结论脑出血患者人院时血糖、血压、心肌酶谱以及D-二聚体与患者疾病严重程度密切相关，这四项指标升高可能提示血肿扩大、死亡或预后不良，临床应该予以高度重视。

Objective To investigate the relationship between blood glueose（Glu）, blood pressure（MAP）, myocardial enzyme and D-dimer with disease severity and prognosis in patients with intracerebral hemorrhage （ICH）. Methods 85 eases of ICH patients were stratified according to Glu ll.lmmol/L, MAP 130mmHg, myocardial enzyme and D-dimer 2.0mg/L. The relationship between above four factors with patients＇ olCH score, NIHSS score, hematoma enlargement, deaths and mRS score were analyzed. Results In 85 cases of ICH, the average oICH score of patients with Glu〉11.1mmol/L, MAP≥ 130mmHg, myocardial enzyme increased and D-dimer≥2.0mg/L were in more than 2 points with significantly higher NIHSS score, compared with patients with Glu≤ 11.1 mmol/L, MAP〈130mmHg, myocardial enzyme no-increased and D-dimer〈2.0mg/L, the differences were statistically significant （P 〈0.05）. The proportion of deaths and patients With mRS scores 〉2 points were significantly higher in patients with Glu〉11. lmmol/ L, MAP≥ 130mmHg, myocardial enzyme increased and D-dimer≥2.0mg/L, which were risk factors of deaths and unfavourable prognosis; and Glu〉11.1mmol/L, MAP≥130mmHg, D-dimer≥2.0mg/L were risk factors of hematoma enlargement. Conclusion For patients with intraeerebral hemorrhage, blood glucose, blood pressure, myocardial enzyme and D-dimer on admission was closely related to the severity and unfavorable prognosis of the disease. The increasing of these four indexes may be suggested to be hematoma enlargement, death or poor prognosis and deserved further investigation.