动脉瘤性蛛网膜下腔出血脑脊液红细胞水平与脑积水的关系

Relationship between the erythrocytes in cerebrospinal fluid and hydrocephalus in aneurysmal subarachnoid hemorrhage.

目的研究动脉瘤性蛛网膜下腔出血(aSAH)患者脑脊液红细胞水平与脑积水的关系。方法选择铜川市人民医院北院2017年5月至2019年5月期间收治的78例aSAH患者为研究对象,在入院14 d时判断患者是否合并脑积水将其分为脑积水组(n=23)和无脑积水组(n=55),比较两组患者的年龄、性别、是否合并高血压、是否合并糖尿病、SAH次数、Hunt-Hess分级以及动脉瘤位置等临床资料的差异;在入院1 d、7 d、14 d测定脑脊液红细胞计数。结果脑积水组与无脑积水组患者的性别、合并高血压、合并糖尿病、SAH次数和动脉瘤位置比较差异均无统计学意义(P>0.05);脑积水组和无脑积水组患者年龄[(62.58±7.28)岁vs(58.39±6.15)岁]、Hunt-Hess分级[(3.48±1.08)级vs(2.07±0.84)级]、合并脑室积血比例[60.87%vs 29.09%]比较,脑积水组明显高于无脑积水组,差异均有统计学意义(P<0.05);脑积水组和无脑积水组患者入院7 d的脑脊液红细胞计数分别为(13.8±1.4)×10^9/L、(11.4±1.8)×10^9/L,在入院14 d的脑脊液红细胞计数分别为(15.8±2.8)×10^9/L、(12.0±2.4)×10^9/L,脑积水组明显高于无脑积水组,差异均有统计学意义(P<0.05)。结论年龄、Hunt-Hess分级以及脑室积血与动脉瘤性蛛网膜下腔出血患者脑积水的发生密切相关,且合并脑积水者其脑脊液红细胞水平更高。

Objective To analyze the occurrence and influencing factors of hydrocephalus in patients with aneurysmal subarachnoid hemorrhage,and to analyze the relationship between erythrocytes in cerebrospinal fluid(CSF)and hydrocephalus.Methods A total of 78 patients with aneurysmal subarachnoid hemorrhage,who admitted to Department of Neurology,North Hospital,Tongchuan People's Hospital,from May 2017 to May 2019,were selected as the study objects.After 14 days of admission,the patients were divided into the hydrocephalus group(n=23)and non-hydrocephalus group(n=55).The age,gender,whether combined with hypertension,whether combined with diabetes,number of SAH,Hunt-Hess grade and location of aneurysm of the two groups were compared.On the first day,the seventh day and the fourteenth day of admission,red blood cell count in CSF was measured.Results There was no significant difference between the hydrocephalus group and non-hydrocephalus group in gender,whether combined with hypertension,whether combined with diabetes,SAH frequency and aneurysm location(all P>0.05);the age,Hunt-Hess grade,proportion with intraventricular hemorrhage in the hydrocephalus group were(62.58±7.28)years,3.48±1.08,60.87%,respectively,which were significantly higher than corresponding(58.39±6.15)years,2.07±0.84,29.09%in the non-hydrocephalus group(all P<0.05).Seven days after admission,red blood cell count in cerebrospinal fluid of the hydrocephalus group was(13.8±1.4)×10^9/L versus(11.4±1.8)×10^9/L of the non-hydrocephalus group(P<0.05);at 14 d after admission,red blood cell count in cerebrospinal fluid of the hydrocephalus group was(15.8±2.8)×10^9/L versus(12.0±2.4)×10^9/L of the non-hydrocephalus group(P<0.05).Conclusion Age,Hunt-Hess grade and intraventricular hematocele are closely related for the occurrence of hydrocephalus in patients with aneurysmal subarachnoid hemorrhage,and the level of erythrocyte in CSF is higher in patients with hydrocephalus.