老年脑出血昏迷患者继发MODS的相关因素分析

Risk factors for secondary MODS in elderly coma patients due to cerebral hemorrhage

目的分析老年脑出血昏迷患者继发多器官功能障碍综合征（MODS）的相关因素，为有效防治老年脑出血昏迷患者继发MODS提供临床依据。 方法选择78例老年脑出血昏迷患者作为研究对象，根据住院期间内是否继发MODS分为MODS组和无MODS组，比较两组患者的定量参数，并通过多因素Logistic回归分析法分析MODS发生的独立危险因素。 结果78例（39.74%）患者中31例出现MODS；MODS组白细胞介素-1（IL-1）、白细胞介素-10（IL-10）、C-反应蛋白（CRP）、APACHEⅡ评分、血糖、脑出血体积显著高于无MODS组，GCS评分、血清白蛋白显著低于无MODS组，差异有统计学意义（P〈0.05）；多因素Logistic回归分析结果显示，血糖、APACHEⅡ评分、脑出血体积、血清白蛋白、IL-6及IL-10是老年脑出血昏迷患者继发MODS的独立危险因素（P〈0.05）。 结论炎症反应、血糖水平、脑出血体积、APACHEⅡ评分、营养状况与老年脑出血昏迷患者继发MODS密切相关，要改善患者全身状况，有效控制血糖水平，以减少MODS的发生。

ObjectiveTo analyze the risk factors for secondary multiple organ dysfunction syndrome（MODS） in elderly coma patients due to cerebral hemorrhage, in order to provide clinical evidence for the effective prevention and treatment of MODS in elderly coma patients due to cerebral hemorrhage. MethodsSeventy-eight senile cerebral hemorrhage coma patients were selected, and were divided into MODS group and non MODS group during hospitalization, the quantitative parameters were compared between the two groups, and the independent risk factors of MODS were analyzed by Logistic regression analysis. ResultsThere were 31 patients （18.25%） with MODS among the 78 patients; The scores of IL-1, IL-10, CRP, APACHE-Ⅱ, blood glucose and cerebral hemorrhage in MODS group were significantly higher than those of patients without MODS group, GCS score and serum albumin were significantly lower than those of patients without MODS group, the differences were significant （P〈0.05）; Logistic regression analysis showed that blood glucose, APACHE Ⅱ score, cerebral hemorrhage volume, serum albumin, IL-6 and IL-10 were the independent risk factors for MODS in elderly patients with cerebral hemorrhage （P〈0.05）. ConclusionsInflammatory response, blood glucose level, cerebral hemorrhage volume, APACHE Ⅱ score, nutritional status are closely correlated with the elderly cerebral hemorrhage coma patients, improve the patient＇s general condition, effectively control blood sugar levels, and reduce the occurrence of MODS is needed.