自发性脑出血患者血清皮质醇含量变化的相关性研究  

Serum cortisol changes in spontaneous intracerebral hemorrhage patients

作　　者：杨彬[1] 于思淼 王亮[1] 刘晓智[1] 赵玉军[1] 刘振林[1] 

机构地区：[1]天津中医药大学研究生院,天津市第五中心医院神经外科,300450

出　　处：《中华神经外科杂志》2014年第6期596-599,共4页Chinese Journal of Neurosurgery

基　　金：天津市滨海新区医药卫生科研基金项目（2012BWKL001）,天津市滨海新区塘沽科技发展专项资金项目（2012MS05-04）

摘　　要：目的研究自发性脑出血后患者血清总皮质醇、皮质醇结合蛋白、游离皮质醇及游离皮质醇指数的变化，探讨其与患者病情轻重程度以及预后的关系。方法筛选92例自发性脑出血患者，采用免疫分析法于患者发病后1、3、7、10和14d晨6：00连续测定血清总皮质醇、皮质醇结合蛋白、游离皮质醇，并计算出游离皮质醇指数，采用SPSS16．0统计学软件对实验结果数据进行分析研究，以P〈0．05为差异有统计学意义。结果发病第1天观察组较对照组血清总皮质醇、游离皮质醇和游离皮质醇指数均升高（P〈0．001），之后逐渐下降。而皮质醇结合蛋白与对照组差异无统计学意义（P〉0．05），之后逐渐升高。血清皮质醇水平低下的自发性脑出血患者与血清皮质醇水平正常的患者比较预后不良（P〈0．05）。结论自发性脑出血可引起HPA轴的迅速激活，故发病后机体内的应激激素水平是升高的。当病情危重时，机体应激反应过于强烈，导致HPA轴衰竭，出现皮质醇不足，最终影响患者预后。Objective To study the changes of total cortisol,cortisol binding globulin,free cortisol and free cortisol index in spontaneous cerebral hemorrhage patients, and to discuss the relationship between the changes and disease severity and the prognosis. Methods 92 patients with spontaneous intracerebral hemorrhage were enrolled in this study. The serum were collected at 6 am at the 1st day,3rd day,7th day, 10th day and 14th day. The total cortisol,cortisol binding globulin and free cortisol were analyzed using of immunity method. The free cortisol index was calculated by Coolens equation. The data were analyzed with SPSS 16. 0, Results The levels of total cortisol,free cortisol and free cortisol index showed significantly increased and got peak at the 1st day （ P 〈 0. 001 ）, and then gradually declined. The cortisol binding protein at the onset had no obvious difference （ P 〉 0. 05 ）, and then gradually increased. To compare the low cortisol spontaneous cerebral hemorrhage patients and the nomal cortisol spontaneous cerebral hemorrhage patients, the prognosis of the former was worse with statistical significance （P 〈 0.05 ） . Conclusions Quick activation of HPA axis could be caused by spontaneous cerebral hemorrhage. So the stress hormone levels in spontaneous cerebral hemorrhage patients were increased. When in a critical condition, the body＇s stress response was too strong and leaded to HPA axis failure, the cortisol was insufficient, and ultimately affected the prognosis of patients.

关 键 词：自发性脑出血 皮质醇 相关性 

分 类 号：R743.34[医药卫生—神经病学与精神病学]