影响急性脑出血住院患者疾病转归的危险因素分析  

Analysis of risk factors affecting the outcome of hospitalized patients with acute cerebral hemorrhage

作　　者：王淑强 钟文洲[2] 王小言[3] Wang Shuqiang;Zhong Wenzhou;Wang Xiaoyan(Medical Records Room,Haikou People's Hospital,Haikou 570208,Hainan,China;Department of Gastroenterology,Haikou People's Hospital,Haikou 570208,Hainan,China;Department of Neurosurgery,Haikou People's Hospital,Haikou 570208,Hainan,China)

机构地区：[1]海口市人民医院病案室,海南海口570208 [2]海口市人民医院消化内科,海南海口570208 [3]海口市人民医院神经外科,海南海口570208

出　　处：《中国中西医结合急救杂志》2019年第2期207-210,共4页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：海南省卫生计生行业科研项目(18A200160).

摘　　要：目的分析急性脑出血住院患者流行病学特征,筛选出影响患者转归的因素,为制定急性脑出血防治措施提供参考。方法选取2016年5月至2018年5月海口市人民医院收治的急性脑出血住院患者400例,经磁共振成像(MRI)、CT、数字减影血管造影确诊。采用自拟信息表采集患者相关信息,包括性别、年龄、职业、生活习惯(饮酒、吸烟)、发病季节、出血部位、既往史及合并症(高血压、心血管疾病、糖尿病)、血糖、首发与复发等临床资料,分析患者的流行病学特征。采用单因素和多因素Logistics回归分析,筛选影响急性脑出血28d转归的危险因素。结果患者中年龄M70岁、工人、冬季、脑叶出血为主、有高血压病史所占比例最高〔分别为 35.00%(140/400), 36.00%(144/400)、36.75%(147/400), 27.00%(108/400). 58.75%(235/400)],男性明显多于女性[68.25%(273/400)比31.75%(127/400)]. 400例患者入院后死亡88例(占22.00%),出院312例(占78.00%)。单因素分析显示,职业为工人〔优势比(0/0=2.416,95%可信区间(95%C/)=0.258 ~ 6.859,P=0.011〕、不良生活习惯吸烟(0/?= 1.792, 95%C/= 1.107-2.895, P=0.015)和饮酒(0/?= 1.664, 95%C/=1.024-2.713, P=0.040),有高血压(OR=1.730, 95%C/=0.701 ~4.266, P=0.231)、空腹血糖2=7.0 mmol/L(0R=&112, 95%C/=3.631 ~ 20.183, P=0.000)是影响急性脑出血转归的因素;多因素Logistic回归分析显示:职业为工人(Off=0.427, 95%C/=0.221 -0.815, P=0.010)、高血压(OR=2.974, 95%C/= 1.182 ~ 7.489,P=0.022),空腹血糖M7.0 mmol/L(OR=8.974, 95%C/= 3.677 ~ 21.936, P=0.000)是影响急性脑出血转归的主要危险因素,而有效急救措施是急性脑出血转归的保护因素(0ft=0.055, 95%C/=0.218~ 5.164, P=0.002)。结论本院收治的急性脑出血患者年龄以M7()岁为主,男性多于女性;冬季是高发季节?,脑叶是主要出血部位,工人、有高血压病史与高血糖是影响疾病转归的危险因素,而有效急救措施是其保护因素。Objective To investigate the epidemiological characteristics of inpatients with acute cerebral hemorrhage, and to observe the different influencing factors on the outcome of the disease, so as to provide a reference for formulating prevention and treatment measures. Methods Four hundred in-patients with acute cerebral hemorrhage admitted to Haikou People's Hospital from May 2016 to May 2018 were enrolled, and their diagnoses were confirmed by magnetic resonance imaging (MRI), the CT, digital subtraction angiography (DSA). The patients* relevant information, including gender, age, occupation, life habits (drinking alcohol, smoking), onset season, hemorrhagic site, past medical history and complication (hypertension, cardiovascular disease, diabetes), blood glucose, first episode and recurrence, etc clinical data were collected from the self-designed case information table, the epidemiological characteristics of patients with acute cerebral hemorrhage were analyzed, and the indexes with statistical significance obtained from univariate analysis were included in the multivariate Logistics regression analysis, and the risk factors affecting the 28-day disease outcome of patients with cerebral hemorrhage were screened out. Results Among the 400 in-patients with acute cerebral hemorrhage, the patients with age M 70 years old, being workers, winter onset, hemorrhage mainly in the cerebral lobe and having history of hypertension were the highest [35.00%(140/400), 36.00%(144/400), 36.75%(147/400), 27.00%(108/400), 58.75%(235/400)], and the proportion of males was significantly higher than that of females [68.25%(273/400) vs. 31.75%(127/400)]. Among the 400 inpatients, 88 died after admission, accounting for 22.00%, and 312 patients were discharged, accounting for 78.00%. Univariate analysis showed that workers [odds ratio (OR)= 2.416, 95% confidence interval (95%C7)= 0.258-6.859, P = 0.011], unhealthy living habits: smoking [OR = 1.792, 95%CI = 1.107-2.895, P = 0.015], drinking alcohol (OR = 1.664, 95%CI = 1.024-2.713, P

关 键 词：脑出血 急性 疾病转归 危险因素 保护因素 流行病学 

分 类 号：R743.34[医药卫生—神经病学与精神病学]