摘要
目的既往临床研究表明脑出血患者急性期C反应蛋白（C-reactive protein,CRP）水平显著升高,但CRP水平与基底节区脑出血早期神经功能恶化（early neurological deterioration,END）的关系仍不明确。文中探讨血清CRP和基底节区脑出血END的关系。方法连续收集2010年1月至2012年12月于南京军区南京总医院经头颅CT确诊为基底节区脑出血的患者142例。END定义为48 h内复评加拿大卒中量表（Canadian Stroke Scale,CSS）较入院时减少≥1分。比较END患者组和非END患者组间基线资料,同时Logistic回归分析CRP水平和基底节区脑出血END的相关性。结果纳入的142例基底节区脑出血患者中,31例（21.8%）发生了END。与非END组患者比较,END组患者高血糖症发生率（29.03%vs11.71%,P=0.018）、中性粒细胞计数[（11.8±1.2）×109/L vs（7.8±7.7）×109/L,P=0.019]、CRP（P=0.001）、血肿增大（54.83%vs 19.81%,P=0.001）、血肿体积[（23.6±21.9）m L vs（14.8±12.7）m L,P=0.005]及出血破入脑室率（68.75%vs 28.83%,P〈0.001）的差异均有统计学意义。经Logistic回归分析校正混杂因素后示：CRP（OR=1.072,95%CI：1.034~1.112,P=0.001）、出血破入脑室（OR=4.162,95%CI：1.498~11.564,P=0.006）及血肿增大（OR=5.297,95%CI：1.906~14.723,P=0.001）与住院期间发生END显著相关。ROC曲线分析表明血清CRP水平对基底节区脑出血早期神经功能恶化有预测价值（OR=0.812,95%CI：0.732~0.891,P〈0.001）。结论血清CRP水平升高和基底节区脑出血END显著相关,故可作为该病的重要预测因素。
Objective Clinical studies show that the level of C-reactive protein （CRP） markedly increases in the acute phase of cerebral hemorrhage. However, the correlation of the CRP level with early neurological deterioration （END） in patients with basal ganglia hemorrhage remains unclear. This study investigated the correlation between CRP and END in basal ganglia hemorrhage. Methods This study included 142 cases of basal ganglia hemorrhage diagnosed by cranial CT between Jan 2010 and Dec 2012. END was defined as any decrease in Canadian Stroke Scale （CSS） score ≥ 1 point in the first 48 hours after stroke onset. We compared the baseline data between the END and non-END patients and evaluated the correlation between CRP and END by logistic regression analysis. Results END was found in 31 （21.8%） of the 142 patients. Univariate analysis of the END versus non-END cases showed that hyperglycemia （29.03 vs 11.71%, P = 0. 018）, neutrophil count （ [ 11.8 ± 1.2 ] vs [ 7.8 ± 7.7 ] × 10^9/L, P = 0. 019）, CRP （P =0. 001 ）, hematoma expansion （54.83 vs 19.81%, P =0.001 ）, hematoma volume （ [23.6 ±21.9] vs [ 14.8 ± 12.7] mL, P = 0. 005 ） , and intraventrieular hemorrhage （68.75 vs 28.83 %, P 〈 0.001 ） were significantly associated with END. Logistic regression a- nalysis indicated that the CRP level （ OR = 1. 072, 95% CI： 1. 034 - 1.112, P = 0.001 ）, intraventricular hemorrhage （ OR = 4. 162,95% CI： 1. 498 - 11. 564, P = 0. 006）, and hematoma expansion （OR = 5. 297, 95% CI ： 1. 906 - 14.723, P = 0. 001 ） were correlated with END in the patients during their hospital stay. ROC analysis manifested the predictive value of the CRP level for END in basal ganglia hemorrhage （OR = 0. 812, 95% CI： 0. 732 - 0. 891, P 〈 0. 001 ）. Conclusion The elevated level of CRP is significantly correlated with END in patients with basal ganglia hemorrhage and therefore can be re- garded as a predictive factor for this condition.
出处
《医学研究生学报》
CAS
北大核心
2014年第12期1277-1280,共4页
Journal of Medical Postgraduates
基金
国家自然科学基金(31171016)
南京军区南京总医院科研基金(2012003)
关键词
脑出血
早期神经功能恶化
脑室内出血
血肿增大
C反应蛋白
Cerebral hemorrhage
Early neurological deterioration
Intraventricular hemorrhage
Hematoma expansion
C-re-active protein
