自发性脑干出血的中青年患者与老年患者临床特征差异及预后分析  

Difference of clinical characteristics and risk factors between young patients and senior patients with spontaneous brainstem hemorrhage

作　　者：周祎[1] 李晓溪[1] 李瑾[1] 顾双双[1] ZHOU Yi;LI Xiaoxi;LI Jin(Department of Emergency Medicine,Nanjing Drum Tower Hospital Affiliated to Nanjing University Medical School,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院急诊科,江苏南京210008

出　　处：《中风与神经疾病杂志》2023年第1期25-28,共4页Journal of Apoplexy and Nervous Diseases

摘　　要：目的 本研究旨在探讨自发性脑干出血的中青年患者与老年患者临床特征差异及预后不良的危险因素分析。方法 本研究为回顾性研究,以2013年1月-2021年1月在南京鼓楼医院急诊科就诊的自发性脑干出血患者为研究对象。根据年龄分为中青年组(18~59岁)和老年组(60~90岁)。收集患者的临床资料,单因素统计分析比较两组患者的临床特征差异,多因素Logistic回归分析预后不良的独立危险因素。结果 本研究共纳入202例符合条件的患者,其中中青年组136例,老年组66例。单因素统计分析显示,中青年组预后不良发生率、男性患者比例、入院时昏迷率、手术率、肺炎并发症及NIHSS评分、血肿体积、舒张压、甘油三酯均显著高于老年组(P<0.05)。中青年组GCS评分明显低于老年组(P<0.05)。早期昏迷、低GCS评分、高NIHSS评分、血肿体积大、血糖控制不佳、并发肺炎及鲍曼不动杆菌感染的患者预后相对较差。多因素Logistic回归分析显示,GCS评分是两组患者预后不良的独立危险因素。结论 本研究发现自发性脑干出血的中青年患者比老年患者预后更差,有效地控制危险因素可能会改善最终的临床结局。Objective This study aimed to analyze the difference of clinical characteristics and risk factors for poor outcome between young patients and senior patients with spontaneous brainstem hemorrhage.Methods This was a retrospective study.The patients with spontaneous brainstem hemorrhage who presented to the Nanjing Drum Tower Hospital from January 2013 to January 2021 were enrolled in this study.They were divided into two groups: Youth group(18-59 years old) and Senior group(60-90 years old).General information and clinical data were collected.Univariate analysis was used to compare the clinical characteristics of the two groups, and multivariate logistic regression was used to analyze the independent risk factors for poor prognosis.Results A total of 202 eligible patients were enrolled in this study, including 136 patients in the Youth group and 66 patients in the Senior group.Univariate analysis of the clinical data from the two groups demonstrated that the prevalence of poor outcome, the proportion of male patients, coma on admission, surgery operation, complicated pneumonia and the average NIHSS score, volume of hematoma, DBP,TG were significantly higher in the Youth group than the Senior group(P<0.05).The average GCS score was remarkably lower in the Youth group(P<0.05).Early coma, low GCS score, high NIHSS score, large volume of hematoma, poor glycemic control, complicated pneumonia and Acinetobacter baumannii infection were risk factors for poor prognosis of both group.Multivariate logistic regression showed that low GCS score was an independent predictor for poor prognosis of both group.Conclusion Young patients with spontaneous brainstem hemorrhage had worse prognosis than elderly patients.Avoiding or effective control of risk factors might ameliorate the final outcome.

关 键 词：自发性脑干出血 临床特征 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]