中大量急性自发性幕上脑出血与FIB水平的关系研究  

FIB as a Predictor of Good Outcome in Medium to Large Spontaneous Supratentorial Intracerebral Haemorrhages

作　　者：戴方瑜[1,2] 韩钊[1] 王苹莉[1] 臧秋玲[1] 叶祖森[1] 

机构地区：[1]温州医学院第一附属医院脑血管科,浙江温州325000 [2]舟山市人民医院神经内科,浙江舟山316000

出　　处：《心脑血管病防治》2009年第5期326-327,共2页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

基　　金：温州市科技局Y2004A014

摘　　要：目的:研究FIB水平与中大量自发性幕上脑出血良好转归的关系。方法:153例急性脑出血患者(发病24小时内,首次脑CT扫描出血量≥20ml),在次晨测量FIB,并全面搜集可能与预后相关的其他临床指标;采用病程3个月死亡和改良Rankin Score(MRS)作为预后判断指标;作单因素和多因素Lo-gistic回归分析。结果:去除其他影响因素,FIB≤4.0g/L是中到大量自发性幕上脑出血预后良好的独立预测因素,(OR=1.689,95%CI1.018～2.805)。结论:FIB≤4.0g/L是中～大量自发性幕上脑出血预后良好的独立预测因素。Objective To observe the level of plasma fibrinogen（FIB） and to determine FIB as a potential predictor of outcome in primary medium to large intracerebral haemorrhages （ICH）. Methods Study included 153 patients within 24 hours at the first onset of ICH≥20ml hospitalized in the neurological wards of the first affiliated hospital of Wengzhou Medical College and Zhejiang Zhoushan Hospital. Haematoma volume was measured on computed tomography （CT） at admission. FIB was measured in all patients on the next morning after admission. The other clinical data associated with the prognosis of ICH were routinely obtained, the outcome at the end of 3rd month after the onset of stroke was followed up. Good outcome was defined as modified Rankin score （MILS） ≤2 at the end of 3rd month. Univariate and multiple logistic regression analysis were used respectively to analyze the correlations of 23 clinical indexes to predict the outcome. Results 1 .Among 153 studied patients 75 patients （50.7%） had good outcome. After tmivariate and multiple logistic regression analysis with 23 factors, the independent predictors of good outcome were low FIB（OR = 1. 689, 95 % CI 1.018-2.805）, female（OR= 3.036, 95%CI 1.140 - 8.086）, without stroke or transient ischemic attack tristory（OR = 9.589, 95%CI 2.411 - 38.133）, low scores of National Institutes of Health Stroke Scale（NIHSS）（OR= 4.080, 95%CI 2.091 - 7.960）, low fasting blood glucose （OR= 1.326, 95%CI 1.046- 1.681）, low density lipoprotein（LDL） （OR= 1.933, 95%CI 1.060- 3. 524 ） and without complication（ OR = 3.267, 95 % CI 1. 228 - 8.691 ）. These seven factors were correctly predicted the outcome of 81.1% patients. Conclusions Low plasma fibrinogen （FIB≤4.0g/L） is one of the independent predictors of good outcome in medi um to large intracerebral haemorrhages patients.

关 键 词：自发性幕上脑出血 FIB 急性期 多因素分析方法 水 脑室内出血 人类健康 高死亡率 

分 类 号：R743.3[医药卫生—神经病学与精神病学]