摘要
目的探讨高血压脑出血患者血清同型半胱氨酸(Hcy)、白细胞介素-1β(IL-1β)水平及其与病情严重程度和预后的相关性。方法选取2016年12月—2017年2月收治的84例高血压脑出血作为观察组,选取同期接受体检的健康者84例作为对照组。根据入院时格拉斯哥评分,将观察组分为轻型亚组(12~15分,n=37)、中型亚组(9~12分,n=26)与重型亚组(3~9分,n=21)。比较两组血清Hcy及IL-1β水平变化,分析影响高血压脑出血患者预后的危险因素。结果与对照组比较,轻型亚组、中型亚组、重型亚组Hcy、IL-1β水平升高,差异有统计学意义(P<0.01);与轻型亚组比较,中型亚组、重型亚组Hcy、IL-1β水平升高,差异有统计学意义(P<0.01);与中型亚组比较,重型亚组Hcy、IL-1β水平升高,差异有统计学意义(P<0.05或P<0.01)。观察组随访12个月,存活67例,病死17例,病死率为20.24%。多因素Logistic回归分析显示,合并感染、合并消化道出血、Hcy>15μmol/L及IL-1β>2.50 pg/ml为影响高血压脑出血患者预后的独立危险因素(P<0.01)。结论高血压脑出血患者病情越严重,血清Hcy与IL-1β水平越高,是影响预后的主要危险因素,对临床评估预后具有一定的应用价值。
Objective To investigate the levels of serum homocysteine(Hcy)and interleukin-1β(IL-1β)in patients with hypertensive intracerebral hemorrhage(HIH)and their correlation with severity of the disease and prognosis.Methods Eighty-four HIH treated from December 2016 to February 2017 were selected as the observation group.And 84 healthy persons who received physical examination during the same period were selected as control group.According to the Glasgow score at admission,the observation group was divided into a mild subgroup(12-15 points,n=37),a moderate subgroup(9-12 points,n=26),and a severe subgroup(3-9 points,n=21).The changes of serum Hcy and IL-1βlevels in both groups were compared,and the risk factors affecting the prognosis of patients with HIH were analyzed.Results Compared with the control group,the levels of Hcy and IL-1βin the mild subgroup,the moderate subgroup and the severe subgroup were significantly increased(P<0.01).Compared with the mild subgroup,the levels of Hcy and IL-1βin the moderate subgroup and the severe subgroup were significantly increased(P<0.01).Compared with the moderate subgroup,the above indicators in the severe subgroup were significantly increased(P<0.05 or P<0.01).The observation group was followed up for 12 months,67 patients survived,17 patients died,and the mortality rate was 20.24%.Multivariate Logistic regression analysis showed that combined infection,combined gastrointestinal hemorrhage,Hcy>15μmol/L,and IL-1β>2.50 pg/ml were independent risk factors affecting the prognosis of patients with HIH(P<0.01).Conclusion The more severe the condition of patients with HIH is,the higher the levels of serum Hcy and IL-1βare,which are the main risk factors affecting the prognosis,and have some evaluation value for the prognosis of patients with HIH.
作者
郑占军
许西海
王玉华
高艳
刘波
ZHENG Zhan-jun;XU Xi-hai;WANG Yu-hua;GAO Yan;LIU Bo(Department of Neurology,Sanhe Yanjiao People's Hospital,Sanhe,Hebei 065201,China;Department of Neurosurger,the People's Hospital of Cangzhou,Cangzhou,Hebei 061001,China)
出处
《临床误诊误治》
2020年第6期82-85,共4页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划项目(20200293)。
