重型颅脑损伤后脑心综合征发生的危险因素分析  

Risk factors of cerebrocardiac syndrome following severe traumatic brain injury

作　　者：汤蓓[1] 钟泽[2] 麻建平[1] 胡佳元[1] 沈红卫[1] 吴金平 邱政[3] TANG Bei;ZHONG Ze;MA Jianping;HU Jiayuan;SHEN Hongwei;WU Jinping;QIU Zhen(Department of Intensive Care Unit,the First People’s Hospital of Jiande,Hangzhou 311600,China)

机构地区：[1]建德市第一人民医院重症医学科,311600 [2]建德市第一人民医院心血管内科,311600 [3]建德市第一人民医院脑外科,311600

出　　处：《浙江医学》2020年第20期2185-2188,共4页Zhejiang Medical Journal

基　　金：浙江省医药卫生科技计划项目(2018KY150)。

摘　　要：目的探讨重型颅脑损伤(sTBI)并发脑心综合征(CCS)的危险因素。方法收集2016年9月至2019年9月建德市第一人民医院治疗的106例sTBI患者的性别、年龄、格拉斯哥昏迷(GCS)评分和CRP浓度等资料,观察CCS的发生情况,采用多因素分析CCS发生的独立危险因素,绘制ROC曲线,通过AUC评价这些危险因袭对CCS发生的预测价值。结果106例患者CCS的发生率为54.7%。GCS评分(OR=0.490,95%CI:0.343~0.702,P=0.002)和CRP浓度(OR=1.135,95%CI:1.038~1.242,P=0.012)是CCS发生的独立危险因素。GCS评分(AUC=0.799,95%CI:0.710~0.871,P<0.001)和CRP浓度(AUC=0.700,95%CI:0.604~0.785,P<0.001)对CCS发生有较高的预测价值。结论sTBI后CCS发生率较高,GCS评分和CRP浓度有助于预测CCS的发生。Objective To investigate risk factors of cerebrocardiac syndrome(CCS)following severe traumatic brain injury(sTBI).Methods Sixty patients with sTBI admitted in the First People's Hospital of Jiande between September 2016 and September 2019 were enrolled,among whom CCS occurred in 60 cases(54.7%).The risk factors of CCS following STBI were analyzed with multivariate logistic regression;and the receiver operating characteristic curve(AUC)was used to assess predictive value of variables for CCS occurrence.Results GCS score(OR=0.490,95%CI:0.343-0.702,P=0.002)and serum C-reactive protein(CRP)level(OR=1.135,95%CI:1.038-1.242,P=0.012)were independent risk factors for CCS following sTBI.The area under ROC curve(AUC)of GCS score and serum CRP for predicting CCS was 0.799(95%CI:0.710-0.871,P<0.001)and 0.700(95%CI:0.604-0.785,P<0.001),respectively.Conclusion CCS incidence following sTBI is rather high,the GCS score and serumCRP level can be used for prediction of CCS occurrence.

关 键 词：颅脑损伤 脑心综合征 危险因素 

分 类 号：R651.15[医药卫生—外科学] R742[医药卫生—临床医学]