急性脑血管病引发全身炎症反应综合征／多器官功能障碍综合征临床流行病学分析  

Study on the clinical epidemiological features of acute cerebral stroke inducing systemic inflammatory response syndrome and multiple organ dysfunction syndrome

作　　者：刘海波[1] 田晶[2] 赵节绪[3] 宋德彪[1] 田加坤[1] 

机构地区：[1]吉林大学第二医院急救医学科,长春130041 [2]吉林大学第四医院神经内科 [3]吉林大学第一医院神经内科

出　　处：《中华流行病学杂志》2008年第3期294-296,共3页Chinese Journal of Epidemiology

摘　　要：目的研究急性脑血管病（ACVD）患者引发全身炎症反应综合征（SIRS）和多器官功能障碍（MODS）的发生率、病死率及相关危险因素。方法用流行病学方法前瞻性分析1751例ACVD患者的临床资料。结果SIRS发生率为36．50％，MODS发生率为11．71％，死亡率为45．37％，发生MODS后病情的严重程度及病死率和发生MODS的器官数目呈正相关，患者的年龄、病变部位靠近中线、格拉斯哥昏迷量表（GCS分值）、血糖水平、白细胞计数、既往有慢性疾病（高血压、糖尿病等）病史6项因素是ACVD发生MODS的相关危险因素，病变部位靠近中线及基底动脉系统MODS的发生率高。结论ACVD易引发SIRS和MODS，尤以病灶面积较大、靠近中线多见；可以通过二级预防，降低其发病率及发展程度；通过发病早期对各项危险因素的检测，可了解患者的预后和转归，以便实施早期临床干预。Objective To study the risks on acute cerebral stroke （ACS） inducing systemic inflammatory response syndrome （SIRS） and multiple organ dysfunction syndrome （MODS）. Methods Data from 1751 patients with acute cerebral stroke were studied by prospective analysis. Results In all of the ACS patients,the incidence rate （IR） of SIRS was 36.50% with 205 patients having ACS inducing MODS,to which the IR was 11.71% ,and 93 deaths. The case fatality ratio （CFR） was 45.37%. The pathogeneses condition of patients and the MR after the occurrence of MODS had positive correlation with the numbers of dysfunction organs. Study on single factor analysis revealed that the incidence of MODS had some related risk factors in the ACS inducing MODS,including age, diseased region close to the mean line, GCS,level of blood sugar, blood white cell count .and the chronic disease history etc. The IR of ACS inducing SIRS and MODS was much higher in the condition of the diseased region near the mean line and the ACS of the basilar artery system. Conclusion SIRS seemed the base for MODS while the probability and the development degree were not only involved ACS but also SIRS. MODS induced by ACS could be reduced through the second grade program of disease precaution. The detection of those risk factors in the early period of the ACS course could provide some prediction of the prognosis and turnover, thus some early use of intervention methods might be helpful in the treatment of the disease.

关 键 词：脑卒中 全身炎症反应综合征 多器官功能障碍综合征 危险因素 

分 类 号：R459.7[医药卫生—急诊医学]