脑出血患者预后危险因素分析及血清生化指标的预后意义

Prognostic Risk Factors and the Prognostic Significance of Serum Biochemical Markers in Patients with Cerebral Hemorrhage

目的分析脑出血患者预后危险因素,探讨血清生化指标对于评估脑出血患者预后的临床意义。方法选取该院2016年7月—2017年12月收治的110例脑出血患者,根据患者治疗预后分为预后良好组(68例)和预后不良组(42例),对比两组患者临床资料总结影响患者预后的相关危险因素,对比两组患者入院后3、7、14 d血清生化指标变化。结果年龄、感染、高动脉压、出血量多、高血糖、血红蛋白过低、合并脑疝、入院GCS评分等都是影响患者预后不良的危险因素(P<0.05)。根据多因素Logistic回归分析表明,合并脑疝、出血量等因素是影响高血压脑出血预后的重要危险因素(P<0.05),入院GCS评分是影响高血压脑出血预后的保护性因素。预后不良组入院时、入院3、7、14 d的血红蛋白指标均低于预后良好组(t=3.012、2.987、2.991、3.121,P<0.05)。结论多方面因素会影响脑出血患者预后,动态监测患者血清生化指标可在一定程度上评估患者预后。

Objective To analyze the prognostic risk factors in patients with cerebral hemorrhage and to explore the clinical significance of serum biochemical markers for evaluating the prognosis of patients with cerebral hemorrhage. Methods 110 patients with cerebral hemorrhage admitted from July 2016 to December 2017 in the hospital were divided into two groups： 68 patients with good prognosis and 42 patients with poor prognosis according to the prognosis of patients. The clinical data of the two groups were compared. The related risk factors affecting the prognosis of the patients were compared with changes of serum biochemical indexes at 3, 7, and 14 d after admission to the two groups. Results Age, infection, high arterial pressure, large amount of blood loss, high blood sugar, low hemoglobin, cerebral palsy, GCS score of hospital admission were all risk factors for poor prognosis （P〈0.05）. According to multivariate Logistic regression analysis, factors including cerebral palsy and blood loss were important risk factors for the prognosis of hypertensive intracerebral hemorrhage （P〈0.05）. The admission GCS score was a protective factor for the prognosis of hypertensive intracerebral hemorrhage. The hemoglobin indexes at the 3, 7, and 14 d day after admission in the poor prognosis group were lower than those in the good prognosis group （t=3.012, 2.987, 2.991, 3.121, P〈0.05）. Conclusion Many factors may affect the prognosis of patients with cerebral hemorrhage. Dynamic monitoring of serum biochemical indicators can assess the prognosis of patients to some extent.