CT混合征联合血清低密度脂蛋白水平对自发性脑出血血肿扩大的预测作用  

Prediction of hematoma expansion in spontaneous intracerebral hemorrhage by CT mixed sign combined with serum low-density lipoprotein level

作　　者：杨勇[1] 徐伟[2] 张茂川 YANG Yong;XU Wei;ZHANG Maochuan(Department of Emergency ICU,First People’s Hospital of Chuzhou City,Chuzhou 239000,China)

机构地区：[1]滁州市第一人民医院急诊ICU科,安徽滁州239000 [2]滁州市第一人民医院CT室,安徽滁州239000 [3]滁州市第一人民医院检验科,安徽滁州239000

出　　处：《中风与神经疾病杂志》2022年第10期898-901,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的探讨CT混合征与血清低密度脂蛋白(LDL)水平联合预测自发性脑出血(sICH)血肿扩大的应用价值。方法回顾性分析2020年1月-2022年1月滁州市第一人民医院急诊ICU科收治的100例sICH患者临床资料,分为血肿扩大组(31例)和非血肿扩大组(69例),分析两组一般资料、实验室及影像学指标的差异,通过多因素Logistic回归分析血肿扩大的影响因素,受试者工作特征(ROC)曲线评估CT混合征联合血清LDL水平对血肿扩大的预测价值。结果血肿扩大组收缩压、活化部分凝血活酶时间(APTT)、血清葡萄糖(GLU)、首次复查血肿体积和CT平扫混合征比例均大于非血肿扩大组,入院格拉斯哥昏迷(GCS)评分和血清LDL水平均低于非血肿扩大组(P<0.05)。Logistic回归分析显示,收缩压、入院GCS评分、APTT、LDL、首次复查血肿体积、CT平扫混合征是sICH血肿扩大的独立影响因素(P<0.05)。ROC曲线显示,CT混合征、血清LDL预测sICH血肿扩大的ROC曲线下面积分别为0.757、0.752,均小于二者联合预测的ROC曲线下面积(0.899)(P<0.05)。结论sICH患者血肿扩大受多种因素影响,其中CT扫描混合征和血清LDL与其关系密切,二者联合检测可在一定程度上提高sICH血肿扩大的预测价值。Objective To investigate the application value of CT mixed sign combined with serum LDL level to predict hematoma expansion in sICH.Methods The clinical data of 100 sICH patients admitted to the Emergency ICU Department of Chuzhou First People’s Hospital from January 2020 to January 2022 were retrospectively analyzed,and they were divided into hematoma expansion group(31 cases)and non-hematoma expansion group(69 cases).The differences in general data,laboratory and imaging indicators between the two groups were analyzed,the influencing factors of hematoma expansion were analyzed by multivariate Logistic regression,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of CT mixed sign combined with serum LDL water on hematoma expansion.Results Systolic blood pressure,APTT,GLU,first review of hematoma volume and proportion of mixed signs on CT scan were greater in the hematoma-expanded group than those in the non-hematoma-expanded group,and admission GCS score and serum LDL level were lower than in the non-hematoma-expanded group(P<0.05).Logistic regression analysis showed that systolic blood pressure,admission GCS score,APTT,LDL,first review of hematoma volume,and CT scan mixed sign were independent influencing factors for sICH hematoma enlargement(P<0.05).The ROC curve results showed that the area under the ROC curve(AUC)for predicting sICH hematoma enlargement by CT mixed sign and serum LDL were 0.757 and 0.752,respectively,which were smaller than the AUC for predicting sICH hematoma enlargement by the combination of both(0.899)(P<0.05).Conclusion Hematoma enlargement in patients with sICH is influenced by several factors,among which CT scan mixed sign and serum LDL are closely related to it,and the combined detection of both can improve the predictive value of hematoma enlargement in sICH to a certain extent.

关 键 词：自发性脑出血 血肿扩大 混合征 低密度脂蛋白 预测 

分 类 号：R743.34[医药卫生—神经病学与精神病学]