高血压脑出血患者入院时血总钙水平与预后的相关性  

Correlation between admission blood calcium level and the prognosis of patients with hypertensive intracerebral hemorrhage

作　　者：黄黎莹[1] 赛芳芳[1] 张科蓓[2] 孟超[1] HUANG Liying;SAI Fangfang;ZHANG Kebei;MENG Chao(Department of General Medicine,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China;Department of Radiology,Renji Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200001,China)

机构地区：[1]上海交通大学医学院附属仁济医院全科医学科,上海200001 [2]上海交通大学医学院附属仁济医院放射科,上海200001

出　　处：《检验医学》2022年第5期423-428,共6页Laboratory Medicine

摘　　要：目的探究高血压脑出血患者入院时血清总钙离子(简称血总钙)水平与其发病30 d内死亡和6个月功能预后之间的关系。方法选取高血压脑出血患者107例,收集其入院时的临床资料[年龄、性别、合并症、美国国立卫生研究院卒中量表(NIHSS)评分、颅内血肿体积和部位、实验室相关指标检测结果等],根据入院血总钙水平将患者分为血总钙>2.75 mmol/L组(15例)、血总钙2.25~2.75 mmol/L组(63例)及血总钙<2.25 mmol/L组(29例)。采用改良Rankin量表(mRS)评价患者发病后6个月的功能状态。采用Logistic回归分析评估血总钙水平与高血压脑出血患者发病30 d内死亡及6个月功能预后的关系。采用受试者工作特征(ROC)曲线评价血总钙水平区分高血压脑出血患者预后功能良好和功能较差的效能。结果与血总钙2.25~2.75 mmol/L组和血总钙>2.75 mmol/L组比较,血总钙<2.25mmol/L组入院血肿体积更大(P<0.05),NIHSS评分和mRS评分更高(P<0.05),早期血肿增大例数和30 d内死亡例数更多(P<0.05),3组之间其他指标差异均无统计学意义(P>0.05)。ROC曲线分析结果显示,血总钙水平判断高血压脑出血患者发病30 d内死亡和6个月功能预后的曲线下面积(AUC)分别为0.74、0.71。Logistic回归分析结果显示,血总钙是高血压脑出血患者的入院血肿体积和早期血肿增大的危险因素比值比[(OR)值分别为0.24、0.15,95%可信区间(CI)分别为0.11~0.69、0.08~0.87],血总钙<2.25 mmol/L组发病30 d内死亡和6个月功能预后差的风险分别是血总钙>2.75 mmol/L组的1.12倍和1.39倍。结论低血总钙水平与高血压脑出血患者发病30 d内死亡和6个月功能预后不良有关,检测血总钙水平可能有助于临床判断患者预后。Objective To investigate the correlation between admission blood calcium level and 30 d mortality rate and 6-month functional outcome in patients with hypertensive intracerebral hemorrhage.Methods The data of patient age,sex,complications,the National Institutes of Health Stroke Scale(NIHSS),intracranial hematoma volume and location and clinical laboratory results from 107 patients with hypertensive intracerebral hemorrhage were analyzed retrospectively.The patients were classified into>2.75 mmol/L group(15 cases),2.25-2.75 mmol/L group(63 cases)and<2.25 mmol/L group(29 cases).A modified Rankin Scale(mRS)>2 denoted poor functional outcome at 6 months.The correlations between calcium level,30 d mortality rate and 6-month functional outcome in hypertensive intracerebral hemorrhage was evaluated by Logistic regression analysis.Receiver operating characteristic(ROC)curve was used to distinguish hypertensive intracerebral hemorrhage patients with favorable and unfavorable functional outcome.Results Compared with>2.75 mmol/L group and 2.25-2.75 mmol/L group,the patients in<2.25 mmol/L group were presented with significantly larger intracranial hematoma(P<0.05),higher NIHSS score and mRS score(P<0.05),and more early hematoma enlargement 30 d mortality cases(P<0.05)and there was no statistical significance among the 3 groups(P>0.05).Calcium level at admission predicted 30 d mortality and 6-month functional outcome with areas under curves(AUC)of 0.74 and 0.71,respectively.Calcium levels at admission were correlated with hematoma volume and early hematoma enlargement[odds ratio(OR)=0.24,95%confidence interval(CI)0.11-0.69;OR=0.15,95%CI 0.08-0.87,respectively].The OR of 30 d mortality and poor functional outcome at 6 months of<2.25 mmol/L group were 1.12 and 1.39 as compared with>2.75 mmol/L group.Conclusions A low calcium level at admission is correlated with 30 d mortality and poor 6-month functional outcome for patients with hypertensive intracerebral hemorrhage.Blood calcium level determination may conduce to patients'p

关 键 词：钙离子 高血压脑出血 预后 

分 类 号：R446.1[医药卫生—诊断学]