| 摘要: |
| 目的 探讨高同型半胱氨酸血症的高血压(H型高血压)与高血压脑出血早期血肿扩大及3个月时临床转归和死亡的关系。 方法 纳入2013年1月至2014年12月本科住院的高血压原发性脑出血患者298例,记录其一般资料,在起病6 h内及24 h行CT扫描,同时检测同型半胱氨酸(Hcy)、血糖、胆固醇、纤维蛋白原等及美国国立卫生研究院卒中量表(National Institute of Health Stroke Scale,NIHSS)评分。随访3个月,记录改良Bathel(MBI)量评分及死亡例数。 结果 血浆Hcy水平升高[优势比(odds ratio,OR)=0.356,95%可信区间(confidence interval, CI):0.131~0.826;P＝0.021] 和收缩压增高(OR=1.021,95% CI:1.002~1.028;P＝0.045)是原发性脑出血患者血肿扩大的独立危险因素。血浆Hcy升高(OR= 1.031,95% CI:1.021~1.278;P＝0.035)和收缩压增高(OR=1.141,95% CI:1.011~1.072;P＝0.034)是临床转归不良的独立危险因素。收缩压增高(OR=1.023,95% CI:1.007~1.051;P＝0.021)、血糖高(OR=1.382,95% CI:1.221~1.673;P＝0.004)、Hcy水平增高(OR=1.521,95% CI:1.025~8.096;P＝0.023)是3个月内死亡的独立危险因素。 结论 H型高血压是原发性脑出血早期血肿扩大及3个月时临床转归和死亡的独立预测因素。 |
| 关键词: H型高血压 脑出血 血肿 预后 |
| DOI：10.3724/SP.J.1008.2015.1219 |
| 投稿时间：2015-05-10修订日期：2015-08-05 |
| 基金项目: |
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| Relationship of H-type hypertension with hematoma enlargement and outcome of cerebral hemorrhage patients |
| LI Hua-liang,CHEN Jia-hui,PAN Ping-lei,ZHONG Jian-guo,XIAO Pei-rong*,SHI Hai-cun |
(Department of Neurology, The Third People's Hospital of Yancheng, Yancheng 224005, Jiangsu, China
*Corresponding author.) |
| Abstract: |
| Objective To explore the relationship among high homocysteine hypertension(H-type hypertension), early enlargement of hypertensive intracerebral hematoma and its clinical outcome and death within 3 months. Methods A total of 298 cases with primary cerebral hemorrhage were selected in this study. The data including general information,brain CT scan results within 6 and 24 h, the values of homocysteine(Hcy), blood glucose,cholesterol and fibrinogen, and the scores of National Institute of Health Stroke Scale(NIHSS)were collected. After 3 months follow-up, modified Bathel(MBI)scores and the death tolls were collected as well. Results The increase of plasma Hcy level(odds ratio[OR]=0.356, 95% confidence interval [CI]: 0.131-0.826;P＝0.021)and the elevation of systolic pressure(OR=1.021,95% CI: 1.002-1.028;P＝0.045)were independent risk factors of enlargement hematoma of primary cerebral hemorrhage. The increase of plasma Hcy level(OR=1.031, 95% CI: 1.021-1.278;P＝0.035)and the elevation of systolic pressure(OR=1.141, 95% CI: 1.011-1.072;P＝0.034)were the independent risk factors of clinical poor outcome. Besides,the elevation of systolic pressure(OR=1.023,95% CI: 1.007-1.051;P＝0.021), higher blood glucose(OR=1.382,95% CI: 1.221-1.673;P＝0.004), and the increase of Hcy level(OR=1.521, 95% CI: 1.025-8.096;P＝0.023) were the independent risk factors of death within 3 months. Conclusion H-type hypertension is the independent predictor of early enlargement of hematoma and clinical outcome and death of primary cerebral hemorrhage. |
| Key words: H-type hypertension cerebral hemorrhage hematoma prognosis |
