老年脑出血昏迷患者继发MODS多因素分析  

Multiple factor study of comatose patients with MODS secondary to cerebral hemorrhage in the elderly

作　　者：杨博[1] 谭家余[1] 罗正超[1] 

机构地区：[1]广东中山市博爱医院ICU,中山528400

出　　处：《中国实用神经疾病杂志》2015年第7期25-26,共2页Chinese Journal of Practical Nervous Diseases

摘　　要：目的探讨老年脑出血昏迷患者继发多器官功能障碍综合征(multiple organ dysfunction syndrome,MODS)的主要危险因素。方法临床纳入老年脑出血昏迷患者50例,根据入院后有无发生MODS分为MODS组与非MODS组。患者入院后24h内进行急性生理和慢性健康状况(APACHE-Ⅱ)评分以及格拉斯哥昏迷量表(GCS)评分,同时检测患者血清白介素-1(IL-1)、IL-6、IL-10活性、空腹血糖(FBG)、脑出血体积,分析其与MODS的关系。结果 MODS组患者与非MODS组相比,IL-10水平、FBG水平、APACHE-Ⅱ评分以及出血体积显著升高,而GCS评分显著较低,差异均有统计学意义(P<0.05);多元Logistic回归分析显示,血清IL-10水平、FBG水平、出血体积以及APACHE-Ⅱ评分越大,MODS发生率越高(P<0.05)。结论对于老年脑出血昏迷患者入院后24h内上述指标的变化,均会影响MODS发生率,均能作为老年脑出血昏迷患者继发MODS的早期预测指标。Objective To study the main risk factors of coma patients with secondary multiple organ dysfunction syndrome （MODS） in the elderly with cerebral hemorrhage. Methods 50 cases of elderly patients with cerebral hemorrhage after admis‐sion were selected in our hospital ,according to whether the MODS occurred;they were divided into MODS group and non MODS group. Patients admitted within 24h after the acute physiology and chronic health score （APACHE‐Ⅱ ） and Glasgow coma score （GCS） ,and serum interleukin‐1（IL‐1） ,IL‐6 ,IL‐10 activity ,fasting blood glucose （FBG） ,volume of cerebral hemorrhage ,secondary MODS occurred with the above index linked were analyzed. Results The serum IL‐10 activity ,FBG , APACHE‐Ⅱ score ,and cerebral hemorrhage volume in MODS group were significantly higher than non MODS group ,GCS score was significantly lower than non MODS group ,the difference was significant （P〈0.05）;Multivariate Logistic regression analysis showed that serum IL‐10 activity and APACHE‐Ⅱ score ,FBG and cerebral hemorrhage volume were positive correla‐tion between the occurrence of MODS （P〈0.05）. Conclusion The patients with coma 24h after admission hyperglycemia , cerebral hemorrhage volume higher ,APACHE‐Ⅱ score and serum IL‐10 activity increased in elderly cerebral hemorrhage are both causes the risk factors of secondary MODS ,the above parameters are able to predict indicators as the elderly cerebral hem‐orrhage coma in early clinical secondary MODS.

关 键 词：脑出血昏迷 继发多器官功能障碍综合征 危险因素 

分 类 号：R749.13[医药卫生—神经病学与精神病学]