PVI、CPP与动脉瘤性蛛网膜下腔出血后患者迟发性脑缺血的关系  

Relationship between PVI,CPP and delayed cerebral ischemia in patients with aneurysmal subarachnoid hemorrhage

作　　者：张亚波[1] 杨其侠[2] 王甜甜[3] 冯丽君[1] 秦浩[1] Zhang Yabo;Yang Qixia;Wang Tiantian;Feng Lijun;Qin Hao(Department Neurosurgery,the Zaozhuang Municipal Hospital,Shandong 277100,China)

机构地区：[1]枣庄市立医院神经外科,山东277100 [2]枣庄市立医院药学部,山东277100 [3]枣庄市立医院皮肤科,山东277100

出　　处：《脑与神经疾病杂志》2021年第2期71-75,共5页Journal of Brain and Nervous Diseases

基　　金：山东省医药卫生科技发展计划项目(2018WS019)。

摘　　要：目的探讨血小板体积指数(PVI)、脑灌注压(CPP)与动脉瘤性蛛网膜下腔出血(aSAH)后患者迟发性脑缺血(DCI)的关系。方法选择2016年1月至2018年2月枣庄市立医院诊治的198例aSAH患者,根据是否发生DCI将患者分为DCI组(61例)和NDCI组(137例)。检测PVI和CPP,分析其对aSAH后DCI的预测价值。结果DCI组、NDCI组PVI、CPP均高于对照组(P<0.05),DCI组PVI、CPP高于NDCI组(P<0.05)。Logistic回归分析结果显示Hunt-Hess分级、改良Fisher分级、PVI是aSAH后是否发生DCI的危险因素(P<0.01),CPP是保护性因素(P<0.001)。受试者工作特征曲线(ROC)分析结果显示PVI、CPP、PVI+CPP预测aSAH后DCI的最佳截断值(cut-off)分别为7.31%、75mmHg,曲线下面积(AUC)分别为0.801、0.742、0.892。结论PVI、CPP与aSAH后DCI的发生密切相关,可作为aSAH后DCI的风险预测因子,PVI联合CPP可提高对aSAH后DCI的诊断效能。Objective To investigate the relationship between platelet volume index(PVI),cerebral perfusion pressure(CPP)and delayed cerebral ischemia(DCI)in patients with aneurysmal subarachnoid hemorrhage(aSAH).Methods 198 patients with aneurysmal subarachnoid hemorrhage(aSAH)diagnosed and treated in Zaozhuang municipal hospital from January 2016 to February 2018 were selected.According to whether DCI occurred,the patients were divided into DCI group(61 cases)and NDCI group(137 cases).PVI and CPP were detected and their predictive value for DCI after aSAH was analyzed.Results The PVI and CPP of DCI group and NDCI group were higher than those of the control group(P<0.05),and the PVI and CPP of DCI group were higher than those of NDCI group(P<0.05).Logistic regression analysis showed that Hunt Hess classification and improved Fisher classification and PVI were the risk factors for DCI(P<0.01),and CPP was the protective factor(P<0.001).The results of ROC analysis showed that the best cut-off value(cut off)of DCI predicted by PVI,CPP,and PVI+CPPwas 7.31%and 75 mmHg respectively,and the area under the curve(AUC)was 0.801,0.742 and 0.892 respectively.Conclusion PVI and CPP are closely related to DCI after aSAH,and can be used as risk predictors of DCI after aSAH.PVI combined with CPP can improve the diagnostic efficiency of DCI after aSAH.

关 键 词：血小板体积指数 脑灌注压 动脉瘤性蛛网膜下腔出血 迟发性脑缺血 预测价值 

分 类 号：R743.34[医药卫生—神经病学与精神病学]