首页|凝血酶指标及相关临床特征与自发性脑出血患者预后的相关性分析

凝血酶指标及相关临床特征与自发性脑出血患者预后的相关性分析

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目的 研究凝血酶指标及相关临床特征与自发性脑出血患者预后的相关性。方法 纳入联勤保障部队第九○四医院 2019 年 1 月至 2022 年 1 月收治的 92 例自发性脑出血患者作为研究对象,根据出院 3 个月后改良Rankin评分(mRS)结果将其分为预后良好组(mRS≤2 分,n=65)及预后不良组(mRS>2 分,n=27)。收集患者临床资料,包括性别、年龄、体重指数(BMI)、有无吸烟、有无饮酒、有无高血压、有无糖尿病、有无高脂血、入院时美国国立卫生研究院卒中量表(NIHSS)评分、血肿体积、血肿位置,检测 2 组患者凝血酶生成潜力(ETP)、凝血酶峰值(TPH)、凝血酶达峰时间;通过受试者操作特征曲线(ROC曲线)分析年龄、NIHSS评分、ETP、TPH、凝血酶达峰时间、血肿体积预测自发性脑出血患者预后不良的价值;通过多因素Lo-gistic回归模型分析自发性脑出血患者预后不良的危险因素。结果 预后良好组年龄、NIHSS评分、凝血酶达峰时间、血肿体积小于预后不良组(P<0。05);预后良好组ETP、TPH水平及小脑血肿患者所占比例高于预后不良组(P<0。05);2 组患者在性别构成、BMI、吸烟、饮酒、高血压、糖尿病、高脂血症、脑叶血肿、基底核区血肿、脑干血肿人数方面差异无统计学意义(P>0。05)。经ROC曲线分析证实年龄、NIHSS评分、ETP、TPH、凝血酶达峰时间、血肿体积能够预测自发性脑出血患者预后不良,其曲线下面积分别为 0。598、0。848、0。859、0。862、0。797、0。852,均 P<0。05。经多因素 Logistic回归分析证实,年龄≥59。040 岁、NIHSS评分≥8。195 分、ETP≤420。510 nmol/(L·min)、TPH≤87。395 nmol/L、凝血酶达峰时间≥13。285 min、血肿体积≥12。705 ml、血肿位于小脑以外其他位置是自发性脑出血患者预后不良的危险因素(P<0。05)。结论 年龄、NIHSS评分、ETP、TPH、凝血酶达峰时间、血肿体积、血肿位置与自发性脑出血患者预后不良有一定相关性,能够为脑出血患者临床预后提供参考价值。
Correlation analysis of thrombin indexes and related clinical features with prognosis of patients with spontaneous intracerebral hemorrhage
Objective To study the correlations between thrombin indexes,related clinical features and prognosis of patients with spontaneous intracerebral hemorrhage.Methods Ninety-two patients with spontaneous intracerebral hemorrhage admitted to our hospital from January 2019 to January 2022 were enrolled.According to the results of modified Rankin scale(mRS)3 months after discharge,the patients were divided into good prognosis group(mRS≤2,n=65)and poor prognosis group(mRS>2,n=27).Clinical data were collected,including gender,age,body mass index(BMI),smoking,alcohol consumption,hypertension,diabetes mellitus,hyperlipidemia,National Institutes of Health Stroke Scale(NIHSS)score at admission,hematoma volume,and hematoma location.Endogenous thrombin potential(ETP),thrombin peak height(TPH)and thrombin peak time of the 2 groups were detected.Receiver operating characteristic(ROC)curve was used to analyze the value of age,NIHSS score,ETP,TPH,thrombin peak time and hematoma volume in predicting poor prognosis of patients with spontaneous intracerebral hemorrhage.Multivariate logistic regression was used to analyze the risk factors of poor prognosis in patients with spontaneous intracerebral hemorrhage.Results Age,NIHSS score,thrombin peak time,and hematoma volume in the good prognosis group were significantly lower than those in the poor prognosis group(P<0.05),while ETP,TPH and the proportion of patients with cerebellar hematoma in the good prognosis group were significantly higher than those in the poor prognosis group(P<0.05).There were no significant differences in gender composition,BMI,smoking,alcohol consumption,hypertension,diabetes mellitus,hyperlipidemia,cerebral lobe,basal ganglia or the number of brain stem hematoma between the 2 groups(P>0.05).ROC analysis proved that age,NIHSS score,ETP,TPH,thrombin peak time,and hematoma volume could predict the poor prognosis of patients with spontaneous intracerebral hemorrhage,and the areas under the curve were 0.598,0.848,0.859,0.862,0.797,and 0.852,respectively(P<0.05).Multiple logistic regression analysis confirmed that age≥59.040 years old,NIHSS score≥8.195,ETP≤420.510 nmol/(L·min),TPH≤87.395 nmol/L,thrombin peak time≥13.285 min,hematoma volume≥12.705 ml and hematoma located outside the cerebellum were risk factors for poor prognosis in patients with spontaneous intracerebral hemorrhage(P<0.05).Conclusion Age,NIHSS score,ETP,TPH,thrombin peak time,hematoma volume,and hematoma location are correlated with poor prognosis of patients with spontaneous intracerebral hemorrhage,which can provide reference for the clinical prognosis of patients with cerebral hemorrhage.

Spontaneous intracerebral hemorrhageThrombinHematomaPrognosis

朱玉叶、陈昊阳、王修锁

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213003 江苏 常州,联勤保障部队第九〇四医院常州医疗区神经内科

自发性脑出血 凝血酶 血肿 预后

2024

海军医学杂志
海军医学研究所

海军医学杂志

CSTPCD
影响因子:0.518
ISSN:1009-0754
年,卷(期):2024.45(1)
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