脑出血破入脑室系统患者预后与血清总胆红素水平的相关性研究  

Study on the correlation between the prognosis of patients with intracerebral hemorrhage ruptured into the ventricle system and the level of serum total bilirubin

作　　者：刘玥[1] 党云[2] 张晓辉 赵嘉欣 唐鹏[1] Liu Yue;Dang Yun;Zhang Xiaohui;Zhao Jiaxin;Tang Peng(Third Department of Neurology,the Shaanxi Provincial People's Hospital,Xian 710068,China)

机构地区：[1]陕西省人民医院神经内三科,西安710068 [2]西安医学院第一附属医院

出　　处：《脑与神经疾病杂志》2022年第10期621-624,共4页Journal of Brain and Nervous Diseases

基　　金：陕西省重点研发计划一般项目-社会发展领域(2020SF-332,2022SF-416)。

摘　　要：目的 评价脑出血(ICH)破入脑室患者的临床预后与血清胆红素水平的相关性。方法陕西省人民医院96例ICH住院患者,入院后查头颅CT,收集临床资料如出血部位、出血量以及是否破入脑室系统等,常规抽血化验血总胆红素、直接胆红素等生化指标,评价美国国立卫生研究院卒中量表(NIHSS)和改良Rankin量表(mRS)评分,半年后随访评估mRS。结果根据头颅CT结果显示ICH是否破入脑室系统,将ICH患者分为破入脑室系统组(n=36)和未破入脑室系统组(n=60)。ICH破入脑室系统组患者血清总胆红素和直接胆红素比未破入脑室系统组患者明显升高,差异有统计学意义(P<0.05)。两组ICH患者的血肿位置存在差异,其中破入脑室系统组以丘脑最为多见,而未破入脑室系统组的血肿部位多位于基底核区(P<0.05)。与未破入脑室系统组相比较,破入脑室系统组ICH患者具有较高的出血量、NIHSS和mRS评分,差异有统计学意义(P<0.05)。半年后随访,破入脑室系统组ICH患者的mRS评分比未破入脑室系统组患者高,差异具有统计学意义(P<0.05)。结论ICH破入脑室系统的患者血清总胆红素和直接胆红素均升高,病情更重,且预后更差。Objective To evaluate the correlation between clinical prognosis and serum bilirubin level in patients with intracerebral hemorrhage(ICH) ruptured into the ventricle.Methods 90 hospitalized patients with ICH admitted in Shaanxi Provincial People’ s Hospital were included.At baseline,biochemical tests such as total bilirubin,direct bilirubin and others were taken;National Institutes of Health Stroke Scale(NIHSS) and modified Rankin Score(mRS) were assessed;CT examination of head was ensured;clinical data included the bleeding site,bleeding volume and whether breaking into the ventricle system or not were recorded.Then mRS was reevaluated after six months follow-up.Results The ICH patients were divided into cerebral hemorrhage broken into the ventricle system group(n=36) and ICH not broken into the ventricle system group(n=60) according to the results of craniocerebral CT showed whether ICH broke into the ventricle system or not.The serum levels of total bilirubin and direct bilirubin were significantly higher in the patients with ICH broken into the ventricle system group than in ICH not broken into the ventricle system group(P <0.05).There were significant differences of hematoma location between two groups(P <0.05);hematomas were mostly located at thalamus in ICH broken into the ventricle system group while at basal ganglia in ICH not broken into the ventricle system group.Bleeding volume,NIHSS and mRS scores were all significantly higher in ICH broken into the ventricle system group than in ICH not broken into the ventricle system group(P <0.05).After six months of follow-up,mRS scores were significantly higher in ICH broken into the ventricle system group than in ICH not broken into the ventricle system group(P <0.05).Conclusion The patients with ICH broken into the ventricle system seem to have increased serum total bilirubin and direct bilirubin levels,heavier condition and worse prognosis.

关 键 词：脑出血 脑室系统 血清总胆红素 血清直接胆红素 

分 类 号：R743.34[医药卫生—神经病学与精神病学]