摘要
目的探讨血清电解质(钙、镁、钾、钠、磷、氯)紊乱对缺血性脑卒中患者住院期间死亡的聚集效应。方法纳入2013年12月至2014年5月于苏州市共22家医院接受住院治疗的2433例电解质数据资料完整的缺血性脑卒中患者,分为无电解质紊乱组(1175例),1种电解质紊乱组(802例),2种电解质紊乱组(338例)和3~6种电解质紊乱组(118例)。使用Kaplan-Meier曲线比较不同电解质紊乱组住院期间死亡情况,运用Cox比例风险模型分析电解质紊乱对死亡的聚集效应。结果共有89例(3.7%)患者住院期间死亡。在多因素调整模型中,血清氯(HR 1.72,95%CI 1.10~2.69)、镁(HR 2.82,95%CI 1.60~4.97)和磷(HR 2.01,95%CI 1.17~3.48)紊乱与缺血性脑卒中患者住院期间死亡显著相关。随着电解质紊乱数目越多,患者住院期间死亡风险越高(P=0.011);与无电解质紊乱组相比,出现3~6种电解质紊乱的患者住院期间死亡风险显著增加(HR 2.48,95%CI 1.30~4.72)。结论血清镁、磷、氯紊乱与缺血性脑卒中患者住院期间死亡相关联;且缺血性脑卒中患者的住院期间死亡率随着电解质紊乱数目的增加而增加,即电解质紊乱对缺血性脑卒中患者短期预后存在聚集效应。
Objective To investigate the clustering effect of serum electrolyte disturbances(including calcium,magnesium,potassium,sodium,phosphorus and chlorine)on in-hospital mortality of patients with ischemic stroke.Method We recruited patients with ischemic stroke admitted to the 22 hospitals in Suzhou from December 2013 to May 2014.A total of 2433 patients with complete electrolyte data were included in the present analysis.All patients were divided into four groups according to the number of electrolyte disturbances:without electrolyte disturbance(n=1175),and with 1(n=802)or 2(n=338)or 3-6 electrolyte disturbances(n=118).The in-hospital mortality of the four groups were compared by Kaplan-Meier curves.The Cox proportional hazard model was used to analyze the clustering effect of electrolyte disturbances on death.Results 89 patients(3.7%)died during hospitalization.In the multivariableadjusted models,the disturbances of serum chlorine(HR 1.72,95%CI 1.10-2.69),magnesium(HR 2.82,95%CI 1.60-4.97),and phosphorus(HR 2.01,95%CI 1.17-3.48)were significantly associated with in-hospital mortality.As the number of electrolyte disturbances increased,the risk of inhospital death was higher(P=0.011).Compared with patients without electrolyte disturbance,patients with 3-6 electrolyte disturbances have significantly increased risk of in-hospital death(HR 2.48,95%CI 1.30-4.72).Conclusion Serum magnesium,phosphorus,and chlorine disturbances are associated with in-hospital mortality in patients with ischemic stroke;with the increase in the number of electrolyte disturbances,the in-hospital mortality of patients with ischemic stroke increase,which means that there was a clustering effect of electrolyte disturbances on the short-term prognosis of patients with ischemic stroke.
作者
周丹虹
陈海畅
尤寿江
崔彤
黎秋红
翟万庆
曹勇军
仲崇科
张永红
李红美
ZHOU Dan-hong;CHEN Hai-chang;YOU Shou-jiang;CUI Tong;LI Qiu-hong;ZHAI Wan-qing;CAO Yong-jun;ZHONG Chong-ke;ZHANG Yong-hong;LI Hong-mei(Department of Epidemiology,School of Public Health,Medical College of Soochow University,Suzhou 215123,China;不详)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2021年第6期521-525,共5页
Chinese Journal of Practical Internal Medicine
基金
十三五国家重点研发计划(2017YFC1307600)
国家自然科学基金(81903387)
江苏省自然科学基金面上项目(BK20181438)
苏州大学大学生创新创业训练计划项目(2020xj053)。
关键词
缺血性脑卒中
院内死亡
电解质紊乱
聚集效应
ischemic stroke
in-hospital mortality
electrolyte disturbance
clustering effect
