脑出血患者预后影响因素的多因素分析  

The multivariant analysis of the risk factors of prognosis on patient with intracerebral hemorrhage

作　　者：孙超 杨杰[2] 姜建东[2] 

机构地区：[1]上海市静安老年医院康复科,200040 [2]南京医科大学附属南京第一医院神经内科

出　　处：《卒中与神经疾病》2009年第4期218-221,224,共5页Stroke and Nervous Diseases

摘　　要：目的探讨脑出血患者早期死亡及致残的危险因素。方法回顾性收集2004年9月～2006年6月南京医科大学附属南京第一医院神经内科住院的312例急性脑出血病例,采用电话或写信等方式随访患者发病后3月的生存及残疾情况。采用Logistic回归分析对影响患者死亡及致残的27项危险因素进行单因素和多因素分析。结果脑出血患者周一周二就诊病死率及致残率较其他时间低。影响脑出血患者死亡的危险因素有年龄(P=0.012)、意识障碍(P=0.016)、入院时收缩压(P=0.018)、尿素氮(P=0.036)、低蛋白血症(P=0.000)、合并感染(P=0.000)、合并消化道出血(P=0.031);影响脑出血患者致残的危险因素有性别(P=0.023)、年龄(P=0.000)、意识障碍(P=0.000)、合并感染(P=0.031)。结论高龄、有意识障碍、入院时收缩压高、尿素氮高、有低蛋白血症、合并感染、合并消化道出血是脑出血患者死亡的独立危险因素。性别、年龄、有意识障碍、合并感染是脑出血患者致残的独立危险因素。Objective To investigate the risk factors of early death and residual disability on patient with intracerebral hemorrhage（ICH）. Methods 312 patients with intracerebral hemorrhage were continuously and retrospectively collected from September 2004 to June 2006 in Department of Neurology, of our Hospital. In order to perceive relevant information on death and residual disability,all patients were followed with phone calls or mailing after three months of onset of illness. Monovariant and muhivariant logistic regression were used to analyze risk factors for early death and residual disability. Results Mortality and disability rate were lower on patients with intraeerebral hemorrhage to see a doctor on days after weekend than on weekend and the other days of weekday. The risk factors associated with mortality were age （P = 0. 012）, conscious levels （P = （1. 016）, the systolic pressure on hospitalization （P = 0. 018）, blood uria nitrogen （P = 0. （136）, hypoproteinemia （P = 0. 000）, complicating infection （P = 0. 000） and stress ulcer （P = 0. 031 ）. The risk factors associated with disability rate were sex （P = 0. 023）, age （P = 0. 000）, conscious levels （P = 0. 000）, complicating infection （P = 0. 031 ）. Conclusions The aged lower conscious levels, the higher systolic pressure on hospitalization, blood uria nitrogen,hypoproteinemia,complicating infection and stress ulcer were the risk factors of early death for hospitalized acute ICH. Female, the aged lower conscious levels and complicating infection were the risk factors of early residual disability for hospitalized acute ICH.

关 键 词：脑出血 预后 多因素分析 

分 类 号：R743.34[医药卫生—神经病学与精神病学]