游离脂肪酸对动脉瘤性蛛网膜下隙出血病人预后影响  

INFLUENCE OF FREE FATTY ACID ON THE PROGNOSIS OF PATIENTS WITH ANEURYSMAL SUBARACHNOID HEMORRHAGE

作　　者：王永意 周勇 谢永帆 徐志明[1] 李彤 王伟民 WANG Yongyi;ZHOU Yong;XIE Yongfan;XU Zhiming;LI Tong;WANG Weimin(Department of Neurosurgery,Qingdao Municipal Hospital,The Third Affiliated Hospital of Qingdao University,Qingdao 266011,China)

机构地区：[1]青岛大学附属青岛市市立医院神经外科,山东青岛266011

出　　处：《青岛大学学报（医学版）》2022年第2期233-236,共4页Journal of Qingdao University(Medical Sciences)

基　　金：山东省脑功能重构省级重点实验室项目(2020N-GN002)。

摘　　要：目的 分析血清游离脂肪酸(FFA)对动脉瘤性蛛网膜下隙出血(aSAH)病人临床预后的影响,探讨影响aSAH病人神经功能预后的危险因素。方法 分析2015年9月—2019年12月我院收治的107例aSAH病人的临床资料。根据出院时改良Rankin量表(mRS)评分将病人分为预后良好组和预后不良组,比较两组病人年龄、性别、既往史(吸烟、高血压、糖尿病)、动脉瘤特征(位置、直径)、入院时的Hunt-Hess分级、改良Fisher分级及血脂水平,对病人神经功能预后的影响因素进行单因素分析,并采用多因素Logistic回归分析影响病人预后的独立危险因素。结果 单因素分析显示,年龄(t=-3.053,P=0.003)、高血压(χ^(2)=8.141,P=0.004)、Hunt-Hess分级(χ^(2)=20.420,P<0.001)、改良Fisher分级(χ^(2)=17.060,P<0.001)、责任动脉瘤位置(χ^(2)=5.420,P=0.020)及FFA(Z=-3.357,P=0.001)等与预后显著相关。多因素Logistic回归分析显示,年龄、Hunt-Hess分级、改良Fisher分级、责任动脉瘤位置、FFA是影响病人预后的独立危险因素。结论 血清FFA水平是影响aSAH病人预后的一个独立危险因素。Objective To investigate the influence of serum free fatty acid(FFA) on the prognosis of patients with aneurysmal subarachnoid hemorrhage(aSAH) and the risk factors for the prognosis of neurological function in aSAH patients. Me-thods The clinical data of 107 patients with aSAH who were admitted to our hospital from September 2015 to December 2019 were analyzed. According to the modified Rankin Scale(mRS) score at discharge, the patients were divided into good prognosis group and poor prognosis group. The two groups were compared in terms of age, sex, past history(smoking, hypertension, and diabetes), features of aneurysm(location and diameter), Hunt-Hess grade on admission, modified Fisher grade, and blood lipid levels. A univariate analysis was performed for the influencing factors for the prognosis of neurological function, and a multivariate Logistic regression analysis was used to identify the independent risk factors for prognosis. Results The univariate analysis showed that age(t=-3.053,P=0.003), hypertension(χ^(2)=8.141,P=0.004), Hunt-Hess grade(χ^(2)=20.420,P<0.001), modified Fisher grade(χ^(2)=17.060,P<0.001), location of responsible aneurysm(χ^(2)=5.420,P=0.020), and FFA(Z=-3.357,P=0.001) were significantly associated with prognosis. The multivariate logistic regression analysis showed that age, Hunt-Hess grade, modified Fisher grade, location of responsible aneurysm, and FFA were independent risk factors for prognosis. Conclusion Serum FFA level is an independent risk factor for the prognosis of aSAH patients.

关 键 词：脂肪酸类 非酯化 蛛网膜下隙出血 动脉瘤 预后 危险因素 

分 类 号：R743.35[医药卫生—神经病学与精神病学] R344.7[医药卫生—临床医学]