摘要
目的探讨老年脑出血昏迷患者继发多器官功能障碍综合征(MODS)的主要危险因素。方法选择2010年6月至2012年12月收住重症医学科(ICU)的老年脑出血昏迷患者85例为脑出血组,并分为MODS组和非MODS组,另选择41例健康体检者为对照组。分析入院后24 h内各组间血清白细胞介素(IL)-1、IL-6和IL-10活性及血糖水平的差异,并探索IL-1、IL-6、IL-10、血糖及急性生理和慢性健康状况评分(APACHE)Ⅱ等参数预测脑出血继发MODS的回归模型。结果血清IL-1、IL-6、IL-10活性及血糖水平在对照组、非MODS组和MODS组逐渐增高(P<0.05)。Logistic回归分析显示,血糖水平、血肿体积、血清IL-10活性及APACHEⅡ评分与脑出血昏迷患者继发的MODS密切相关。结论入院24 h内高血糖、血肿体积大、血清IL-10活性升高及APACHEⅡ评分高是老年脑出血昏迷患者继发MODS的重要危险因素。
Objective To explore the major risk factors of multiple organ dysfunction syndrome( MODS) secondary to elderly comatose intracerebral hemorrhage and their role in the prediction of MODS. Methods Eighty five elderly comatose patients with intracerebral hemorrhage( ICH) admitted to Intensive Care Unit in Shanghai Punan Hospital of Pudong New District within 24 h after onset were enrolled as ICH group. These patients were further divided into MODS and non-MODS groups depending on the presence of MODS. Meanwhile,41health-examinees from Punan Health Check Centre were enrolled as control group. The activities of serum IL-1,IL-6 and IL-10 and blood glucose levels were measured and compared. The correlations between MODS secondary to ICH and cytokines,blood glucose and APACHEⅡ scores and hematoma volume as well as related prediction efficiency were analyzed by binary multivariate Logistic regression model. Results The blood glucose level and the serum activities of IL-1,IL-6 and IL-10 were gradually increased among control,non-MODS and MODS groups( P < 0. 05). APACHE Ⅱ scores and hematoma volume were significantly higher in MODS group than those of non-MODS group,while GCS scores were significantly lower than those of non-MODS group( all P < 0. 01). The incidence of MODS positively correlated with blood glucose level,hematoma volume,IL-10 activity and APACHE-Ⅱ scores. Conclusions The activities of serum IL-1,IL-6and IL-10 and blood glucose level are significantly elevated within 24 h after admission to ICU in comatose patients with intracerebral hemorrhage. Hyperglycemia,hematoma volume,serum IL-10 activity and APACHE-Ⅱ score are probably major risk factors for the incidence of MODS secondary to elderly comatose intracerebral hemorrhage.
出处
《中国老年学杂志》
CAS
CSCD
北大核心
2015年第7期1739-1741,共3页
Chinese Journal of Gerontology
基金
上海市浦东新区卫生局卫生科技项目(PW2010A-16)
关键词
脑出血
炎症细胞因子
血糖
多器官功能障碍综合征
Intracerebral hemorrhage
Inflammatory cytokine
Blood glucose
Multiple organ dysfunction syndrome
