血钠水平与颅脑损伤患者炎性反应及短期预后的关系研究  

Relations of Serum Sodium Level with Inflammatory Reaction and Short-term Prognosis in Patients with Craniocerebral Trauma

作　　者：刘飞[1] 方敏 朱正国 徐非凡[1] LIU Fei;FANG Min;ZHU Zhengguo;XU Feifan(Department of Critical Care Medicine,Chizhou People's Hospital,Chizhou 247000,China)

机构地区：[1]安徽省池州市人民医院重症医学科

出　　处：《实用心脑肺血管病杂志》2019年第11期29-34,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：安徽省卫生和计划生育委员会科研计划项目（2016QK009)

摘　　要：背景高钠血症与颅脑损伤患者预后关系复杂且存在异质性,而目前关于血钠水平与颅脑损伤患者短期预后的关系研究报道较少。目的探讨血钠水平与颅脑损伤患者炎性反应及短期预后的关系。方法选取2016年1月-2019年6月池州市人民医院收治的颅脑损伤患者106例,根据出院后6个月格拉斯哥预后量表(CGOS)评分分为预后良好组(CGOS评分≥4分,n=82)和预后不良组(GOS评分<4分,n=24)。比较不同血钠水平、预后良好组与预后不良组患者一般资料[包括年龄、性别、低氧血症发生情况、人院时体温、人院时格拉斯哥昏迷量表(GCS)评分、人院时创伤严重程度(ISS)评分、人院时收缩压(SBP)、人院时舒张压(DBP)、减压手术情况]、实验室检查指标[包括中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白(CRP)、白细胞计数(WBC)、血红蛋白(Hb)、血小板计数(PLT)、纤维蛋白原(FIB)];血钠水平与颅脑损伤患者NLR、CRP、WBC的相关性分析采用Pearson相关分析;颅脑损伤患者血钠水平、短期预后的影响因素分析采用多因素Logistic回归分析。结果 (1) 106例患者中血钠水平正常59例(55.7%)、轻度高钠血症15例(14.2%)、中度高钠血症13例(12.3%)、重度高钠血症19例(17.8%)。不同血钠水平患者年龄、低氧血症发生率、人院时GCS评分、人院时SBP、NLR、CRP、WBC比较,差异有统计学意义(P<0.05);不同血钠水平患者性别、人院时体温、人院时ISS评分、人院时DBP、行减压手术者所占比例、Hb、PLT、FIB比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,年龄、人院时GCS评分、NLR、CRP、WBC是颅脑损伤患者血钠水平的影响因素(P<0.05)。Pearson相关分析结果显示,血钠水平与颅脑损伤患者NLR (r=0.869)、CRP (r=0.791)、WBC (r=0.722)呈正相关(P<0.05)。(2)预后不良组患者年龄、低氧血症发生率、NLR、CRP、WBC及轻度、中度、重度高钠血症发�Background Relationship between hypernatremia and prognosis in patients with craniocerebral trauma is complex and heterogeneous,however there is few research reports about relationship between hypernatremia and shortterm prognosis in patients with craniocerebral trauma.Objective To investigate the relations of serum sodium level with inflammatory reaction and short-term prognosis in patients with craniocerebral trauma.Methods A total of 106 patients with craniocerebral trauma were selected in Chizhou People ’ s Hospital from January 2016 to June 2019,and they were divided into good prognosis group(with GOS score≥4,n=82) and poor prognosis group(with GOS score<4,n=24) according to the GOS score 6 months after discharge.General information(including age,gender,incidence of hypoxemia,body temperature at admission,GCS score at admission,ISS score at admission,SBP at admission,DBP admission and proportion of patients underwent decompression) and laboratory examination results(including NLR,CRP,WBC,Hb,PLT and FIB) in patients with different serum sodium levels,between good prognosis group and poor prognosis group;Pearson correlation analysis was used to analyze the correlations of serum sodium level with NLR,CRP and WBC in patients with craniocerebral trauma;multivariate Logistic regression analysis was used to analyze the influencing factors of serum sodium level and short-term prognosis in patients with craniocerebral trauma.Results(1) Of the 106 patients,59 cases(55.7%) showed normal serum sodium level,15 cases(14.2%) occurred mild hypernatremia,13 cases(12.3%) occurred moderate hypernatremia,and 19 cases(17.8%) occurred severe hypernatremia.There was statistically significant difference in age,incidence of hypoxemia,GCS score at admission,SBP at admission,NLR,CRP and WBC in patients with different serum sodium levels,respectively(P<0.05),while there was no statistically significant difference in gender,body temperature at admission,ISS score at admission,DBP at admission,proportion of patients underwent decompr

关 键 词：颅脑损伤 高钠血症 炎性因子 短期预后 影响因素分析 

分 类 号：R651[医药卫生—外科学]