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6h内及24h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。
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, 95M 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.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2015年第11期1219-1224,共6页
Academic Journal of Second Military Medical University
关键词
H型高血压
脑出血
血肿
预后
H-type hypertension
cerebral hemorrhage
hematoma
prognosis
