血清钙浓度与高血压性脑出血患者预后的相关性研究

Correlation between serum calcium concentration and prognosis in patients with hypertensive intracerebral hemorrhage

目的探讨血钙浓度与高血压脑出血(hypertensive intracerebral hemorrhage, HICH)患者预后之间的关系。方法前瞻性连续纳入在我院入住的HICH患者220例,根据入院时测得的血钙浓度将患者分为正常血钙组145例,低血钙组45例,高血钙组30例,同时收集患者基线资料和头部CT/MRI扫描等结果,随访预后情况使用格拉斯预后量表(Grasse Prognosis Scale, GCS)进行评估;采用多因素Logistic回归分析评估入院时血钙浓度对HICH预后的影响。结果低血钙组血肿量大、格拉斯哥昏迷评分评分低、血肿破入脑室和再出血的风险高、需要手术治疗的比例高,预后不良的比例(71.1%)显著高于正常组(35.1%)和高血钙组(33.3%)(均P<0.05);Logistic回归分析结果显示,低钙血症是影响HICH预后的一个独立危险因素。结论入院时伴有低钙血症的HICH患者病情危重、预后不良的风险高。

Objective To investigate the effect of serum calcium concentration on the prognosis of patients with hypertensive intracerebral hemorrhage(HICH).Methods According to the blood calcium concentration measured at the admission,the patients were divided into three groups,normal blood calcium group(n=145),hypocalcemia group(n=45)and hypercalcemia group(n=30).At the same time,baseline data and head CT/MRI scans were collected,and follow-up prognosis was assessed using Grasse Prognosis Scale(GCS).Multivariate logistic regression analysis was used to evaluate the effect of serum calcium concentration at admission on the prognosis of HICH.Results The hypocalcemia group had a larger amount of hematoma,a lower GCS score,a higher risk of hematoma breaking into the ventricle and rebleeding,and a higher proportion of patients requiring surgery.The proportion of poor prognosis(71.1%)was significantly higher than that of normal group(35.1%)and hypercalcemia group(33.3%)(P<0.05).Logistic regression analysis showed hypocalcemia is an independent risk factor affecting prognosis of HICH.Conclusion HICH patients with hypocalcemia at admission are at high risk of critical illness and poor prognosis.