高血压脑出血患者入院后颅内血肿早期进展的相关危险因素分析

Analysis of risk factors related to early progression of intracranial hem atoma in patients with hypertensive intracerebral hemorrhage after admission

目的:探究高血压脑出血患者入院后颅内血肿早期进展的相关危险因素。方法:收集2017年1月至2022年12月广州市中西医结合医院收治的高血压脑出血患者的临床资料。将其中入院后24小时内出现血肿增加情况的患者作为加重组,将未增加的患者作为对照组。收集两组患者的性别、年龄、入院格拉斯哥昏迷量表(Glasgow Coma Score,GCS)评分、发病到入院时长、是否合并高血压和糖尿病、血压波动值、入院时血肿量等资料,分析影响血肿早期增加的危险因素。结果:单因素分析显示,两组患者的年龄、性别、GCS评分、发病至入院时间和入院时血肿量相比,无统计学差异(P>0.05)。两组患者的血压波幅、合并高血压和糖尿病的比例相比,有统计学差异(P<0.05)。多因素逻辑回归分析发现,血压波幅大、发病至入院时间短、合并高血压和糖尿病是影响早期血肿进展的独立危险因素(OR=1.408,P<0.001;OR=2.104,P=0.046;OR=1.495,P=0.037;OR=3.294,P=0.002)。结论:高血压脑出血患者的血压波幅大、发病至入院时间短、合并高血压和糖尿病等情况是影响其颅内血肿早期进展的危险因素。

Objective:To explore the risk factors related to the early progression of intracranial hematoma in patients with hypertensive intracerebral hemorrhage after admission.Methods:The clinical data of patients with hypertensive cerebral hemorrhage admitted to Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January 2017 to December 2022 were collected.Patients with increased hematoma within 24 hours after admission were included as the plus group,and patients without increased hematoma were included as the control group.Data such as gender,age,Glasgow Coma Score(GCS)score,duration from onset to admission,whether combined with hypertension and diabetes,fluctuation value of blood pressure,amount of hematoma at admission were collected from the two groups of patients,and the risk factors affecting the early increase of hematoma were analyzed.Results:Univariate analysis showed that there were no significant differences in age,gender,GCS score,time from onset to admission and the amount of hematoma on admission between the two groups(P>0.05).There were statistical differences in the amplitude of blood pressure and the proportion of patients with hypertension and diabetes between the two groups(P<0.05).Multivariate logistic regression analysis showed that large blood pressure amplitude,short time from onset to hospital admission,combined with hypertension and diabetes were independent risk factors for early hematoma progression(OR=1.408,P<0.001;OR=2.104,P=0.046;OR=1.495,P=0.037;OR=3.294,P=0.002).Conclusion:Large amplitude of blood pressure,short time from onset to admission,combined with hypertension and diabetes are risk factors affecting the early progression of intracranial hematoma in hypertensive intracerebral hemorrhage patients.