青年与老年急性原发性脑出血患者血肿吸收速度的影响因素  

The influence factors of the primary acute cerebral hemorrhage hematoma absorption rate in young and old patients

作　　者：蒋邦治 李裕茂 张健[2] 陈秀清 黄丽祯 

机构地区：[1]广西桂林市妇幼保健院神经内科,桂林541001 [2]广东中山市人民医院介入治疗室,中山528403

出　　处：《中国实用神经疾病杂志》2016年第11期9-11,共3页Chinese Journal of Practical Nervous Diseases

摘　　要：目的分析影响青年与老年急性原发性脑出血患者血肿吸收速度的因素。方法回顾性分析我院2006-01-2015-01神经内科收治的208例经保守治疗的急性原发性脑出血患者的临床资料,根据患者的年龄分为青年组（〈45岁）和老年组（≥60岁）,其中青年组患者76例,老年组患者132例,采用多田法计算患者的血肿吸收速度,分析2组患者血肿吸收的影响因素。结果 208例患者的血肿吸收速度0.21-2.36 mL/d,平均（0.62±0.19）mL/d;青年组血肿吸收快者33例（43.42%）,血肿吸收慢者43例（56.58%）;老年组血肿吸收快者49例（37.12%）,血肿吸收慢者83例（62.88%）。单因素分析结果显示,青年组患者与血肿吸收速度显著相关的因素分别是：出血部位（基底节和丘脑）、GCS得分、NIHSS评分、糖化血红蛋白和出血体积;而老年组患者与血肿吸收速度显著相关的因素则分别为：出血部位（脑干）、GCS得分、NIHSS评分、胆固醇、出血体积和血浆D-二聚体。多元Logistic回归分析结果显示,青年组患者血肿吸收速度与出血体积和GCS得分呈正相关,与糖化血红蛋白呈负相关;老年组患者血肿吸收速度则与出血体积、GCS评分和血浆D-二聚体呈正相关,与NIHSS得分和胆固醇水平呈负相关。结论青年和老年急性原发性脑出血患者血肿吸收速度的影响因素各有不同,在临床治疗实践中应予以区别对待。Objective To analyze the influence factors of hematoma absorption rate in young and old patients with the primary acute cerebral hemorrhage.Methods Two hundred and eight patients with acute cerebral hemorrhage in our hospital from January 2006 to January 2015 were retrospectively analyzed.The young（45years）and elderly（≥60years）patients with acute primary cerebral hemorrhage from January 2012 to January 2012 in our hospital were selected as the research objects,76 young patients and 132 elderly patients.The hematoma absorption rate was calculated by the Coniglobus formula,and the influence factors on the hematoma absorption rate were analyzed between two groups.Results The hematoma absorption rate of 208 cases was 0.21~2.36mL/d,and the average absorption rate was（0.62±0.19）mL/d.The fast hematoma absorption was 33cases（43.42%）,and the slow hematoma absorption were 43cases（56.58%）in the youth group.The fast hematoma absorption was49cases（37.12%）,and the slow hematoma absorption cases were 83（62.88%）in the elderly group.Single factor analysis showed that,significant correlated factors of hematoma absorption rate in the youth patients were bleeding site（basal ganglia and thalamus）,GCS score,NIHSS score,hemoglobin and bleeding volume;significant correlated factors of hematoma absorption rate in the elderly patients were bleeding site（brainstem）,GCS score,NIHSS score,hemorrhage volume,cholesterol and plasma D-Dimer.Multivariate logistic regression analysis showed that,the hematoma absorption rate was positively correlated with bleeding volume and GCS score,but negatively correlated with glycosylated hemoglobin in the youth patients.The hematoma absorption rate was positively correlated with the bleeding volume,GCS score and plasma D-Dimer,but negatively correlated with the score of NIHSS and cholesterol levels in the elderly patients.Conclusion The influence factors of hematoma absorption rate in the youth and elderly patients with primary cerebral hemorrhage are different,and pati

关 键 词：青年 老年 急性原发性脑出血 血肿吸收速度 影响因素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]