老年脑梗死患者低血磷的临床意义  

Clinical significance of hypophosphatemia in elderly patients with cerebral infarction

作　　者：李英梅[1] 李彩荣[1] 刘欣艳[1] 余雪君[1] 张莉[1] 刘闻莺[1] 韩敏[1] 车在前[2,3] 杨根妹[1] 

机构地区：[1]上海中医药大学附属普陀医院老年科,上海200062 [2]上海交通大学医学院附属瑞金医院急诊科 [3]上海交通大学附属瑞金医院北院急诊科

出　　处：《上海医学》2014年第5期430-433,共4页Shanghai Medical Journal

摘　　要：目的探讨发生低血磷的老年前循环脑梗死患者的临床特点及其预后。方法选取上海中医药大学附属普陀医院老年科收治的前循环脑梗死患者,收集其临床资料并随访其临床结局。按照不同血磷水平分为低血磷组和正常血磷组,分析两组患者的临床特点及其预后。结果两组间留置鼻饲管的构成比的差异无统计学意义(P>0.05),低血磷组入院时的C反应蛋白(CRP)水平,院内感染、肺部感染发生率均显著高于正常血磷组(P值分别<0.01、0.05)。低血磷组患者的抗生素使用时间和平均住院时间均显著长于正常血磷组(P值分别<0.01、0.05);转入重症监护病房(ICU)的患者构成比、住院期间病死率均显著高于正常血磷组(P值均<0.05)。按照患者出院时血磷水平对存活患者进行再次分组后,两组间留置鼻饲管的构成比的差异无统计学意义(P>0.05),而低血磷组患者1年内再住院率和病死率均显著高于正常血磷组(P值均<0.05)。结论血磷水平在一定程度上反映了前循环脑梗死患者的病情严重程度,有助于判断患者预后。Objective To investigate clinical features and prognosis of hypophosphatemia in elderly patients with anterior circulation cerebral infarction. Methods We retrospectively analyzed the clinical data of the patients with anterior circulation cerebral infarction treated in our hospital and followed up the clinical outcomes. The patients were divided into 2 groups according to different serum phosphorus levels. The clinical characteristics and prognosis were analyzed. Results There was no significant difference in enteral nutrition ratio between two groups （ P〈0.05）. The C-reaction protein （CRP） level and the incidence of nosocomial infection and pulmonary infection on admission in hypophosphatemia group were significantly higher than those in normal phosphorus group （P〈0.01 or P〈0.05）. The antibiotics consumption time and the average hospitalization time in hypophosphatemia group were significantly longer than those in normal phosphorus group （P〈0.01 or P〈 0.05）. Intensive care unit （ICU） admission rate and in-hospital mortality rate in hypophosphatemia group were significantly higher than those in normal phosphorus group （both P 〈 0. 05）. The survivors were regrouped according to the phosphorus level after the patients were discharged. There was no significant difference in enteral nutrition ratio between the two subgroups （P〉0. 05）, but one-year rehospitalization rate and mortality in hypophosphatemia patients were significantly higher than those with normal phosphorus （both P 〈 0. 05）. Conclusion Serum phosphorus level, to some extent, reflects the severity of anterior circulation cerebral infarction and provides reliable evidence for prognosis.

关 键 词：脑梗死 低血磷 预后 

分 类 号：R743.33[医药卫生—神经病学与精神病学]