血肌酐水平预测脑干出血预后的价值  

Predictive value of serum creatinine for the prognosis in brain stem hemorrhage

作　　者：林绍鹏[1] 叶珊[2] 魏伟民 

机构地区：[1]广州医科大学第二附属医院急诊科,510260 [2]广州医科大学第二附属医院老年病科,510260 [3]增城市人民医院神经内科

出　　处：《中华生物医学工程杂志》2013年第3期197-199,共3页Chinese Journal of Biomedical Engineering

基　　金：广东省科技计划项目（20118061300004）

摘　　要：目的确定判断脑干出血患者预后的血肌酐临界值，分析血肌酐与格拉斯哥昏迷评分（GCS）相关性，探讨血肌酐对评估脑干出血预后的价值。方法回顾性分析2010年6月至2012年6月期间本院收治的77例自发性脑干出血患者的临床资料，根据预后将患者分为生存组（n=51）和病死组（n=26）。对两组患者行GCS评分和血肌酐检测，根据血肌酐水平绘制血肌酐预测脑干出血患者病死情况的受试者工作曲线（ROC）并评估血肌酐的最优截断点cut-off值。以cut．off值为界将患者分为血肌酐〈96．000μmol／L组（n=39）和i〉96．000μmol／L组（n=38），对比两组患者的GCS评分和实际病死率。结果病死组GCS评分低于生存组，而血肌酐水平高于生存组（均P〈0．05）。根据ROC曲线，以血肌酐水平来预测患者死亡事件，其cut．off值为96．000μmol／L，其诊断灵敏度为80．77％，特异度为66．67％。血肌酐〈96．000μmol／L组和I〉96．000μm01]L组患者的GCS评分及实际病死率差异均有统计学意义（均P〈0．05）。结论血肌酐水平可应用于脑干出血患者病情严重程度的评估以及预测死亡危险度。Objective To determine the threshold of serum creatinine （Scr）for predicting the prognosis of brain stem hemorrhage （BSH）, and to examine the correlation of Scr with Glasgow coma score （GCS）. And to inverstigate Scr for assessing the prognostic value of brain stem hemorrhage. Methods Clinical data of 77 patients with spontaneous BSH who were admitted to The Second Affiliated Hospital, Guangzhou Medical University between June 2010 and June 2012 were retrospectively analyzed. Patients were divied into survival group （n=51） and mortality group （n=26）. The levels of Scr and GCS were assessed. Receiver operation characteristic （ROC） curve predicting brain stem hemorrhage died situations was drawed according to Scr levels. Determination of the cut-off value derived from ROC curve entailed allocation to the 〈 96.000 μmol/L subgroup （n=39） and i〉96.000 μmol/L （n=38） subgroup, respectively. The GCS and mortality between both groups were compared. Results Compared with the survival group, the mortality group had lower GCS and higher level of Scr （both P〈0.05）. The cut-off value of Ser for predicting mortality, as derived from ROC curve, was 96.000 μmol/L （sensitivity： 80.77%, specificity： 66.67%）. The difference in mortality and GCS between Scr 〈 96.000 μmol/L and Scr 〉196.000 μmol/L subgroups was significant （all P〈0.05）. Conclusion The Scr may be used to evaluate the disease severity and predict the mortality of BSH.

关 键 词：脑干出血 肌酐 格拉斯哥预后评分 ROC曲线 

分 类 号：R743.34[医药卫生—神经病学与精神病学]