老年脑出血昏迷患者继发多器官功能障碍综合征的危险因素分析  

Risk Factors for Secondary Multiple Organ Dysfunction Syndrome in Elderly Comatose Patients due to Cerebral Hemorrhage

作　　者：冼文川[1] 孙小聪[2] 李新梅[3] 梁国聪[1] 

机构地区：[1]广东医学院附属医院神经内科 [2]广东医学院附属医院危重医学科 [3]湛江中心人民医院危重医学科,广东湛江524001

出　　处：《辽宁医学院学报》2015年第2期61-63,共3页Journal of Liaoning Medical University (LNMU) Bimonthly

摘　　要：目的研究老年脑出血昏迷患者继发多器官功能障碍综合征(MODS)的危险因素。方法选取2013年7月至2014年7月收入我院的88例老年脑出血昏迷的患者,前24 h内进行格拉斯哥评分(GCS)和急性生理和慢性健康状况(APACHE-Ⅱ)评分,检测脑出血体积、白细胞介素(IL)1、6、10活性、血糖水平,对住院期间患者的MODS进行检测。根据住院期间有无继发MODS,将患者分为34例MODS组和53例非MODS组,并对MODS组和非MODS组患者的上述指标进行评价,分析MODS与GCS、APACHE-Ⅱ评分、脑出血体积、IL-1、6、10、血糖水平等因素的关系。结果MODS组GCS显著低于非MODS组,APACHE-Ⅱ评分、脑出血体积、血清IL-10活性、血糖水平显著高于非MODS组(P<0.01)。MODS与APACHE-Ⅱ评分、脑出血体积、血糖水平及IL-10等因素呈正相关。结论脑出血昏迷的老年患者APACHE-Ⅱ评分高、血糖高、脑出血体积大、血清IL-10活性增加,这些均为导致MODS危险因素,可有效预测MODS的发生。Objective To investigate the major risk factors for secondary multiple organ dysfunction syndrome（ MODS） in elderly comatose patients with cerebral hemorrhage. Methods 88 cases of comatose patients with cerebral hemorrhage were selected for the study. Their APACHE- Ⅱ,GCS,serum IL- 1,6,10 activities,blood glucose level and cerebral hemorrhage volume were measured within the first 24 h after their admission. The patients were divided into MODS group（ n = 34） and non- MODS group（ n =54）. The parameters mentioned above were compared between the two groups. The correlation of MODS with the serum IL- 1,the 6and 10 activities,the APACHE- Ⅱscore,the GCS score,the blood glucose level and the cerebral hemorrhage volume was analyzed by multivariate logistic regression analysis. Results For the MODS group,the serum IL- 10 activity,APACHE- Ⅱscore,blood glucose level and cerebral hemorrhage volume were significantly higher compared with that of the non- MODS groups but the GCS score of the MODS group was significantly lower than the non- MODS group（ P〈0. 01）. The incidence of MODS was positively correlated with the serum IL- 10 activity,the APACHE- Ⅱscores,the blood glucose level,and the cerebral hemorrhage volume. Conclusion High blood glucose level,cerebral hemorrhage volume,serum IL- 10 activity and APACHE- Ⅱscore are the major risk factors for secondary MODS. These parameters can predict the occurrence of MODS in elderly comatose patients with cerebral hemorrhage within the 24 h after admission.

关 键 词：昏迷 脑出血 多器官功能衰竭 危险因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]