自发性脑出血评分联合凝血参数对自发性脑出血患者预后有评估价值  

Spontaneous intracerebral cerebral hemorrhage score combined with coagulation parameters is of prognostic value in patients with spontaneous intracerebral cerebral hemorrhage

作　　者：朱家双 杨玉升 黄建华[1] 蒋文韬[1] ZHU Jia-shuang;YANG Yu-sheng;HUANG Jian-hua;JIANG Wen-tao(Department of Emergency and Critical Care Medicine,Bengbu First People's Hospital,Anhui Bengbu 233000,China)

机构地区：[1]蚌埠市第一人民医院急诊重症医学科,安徽蚌埠233000

出　　处：《内科急危重症杂志》2023年第1期46-48,80,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的:探讨自发性脑出血(SICH)评分联合凝血参数对SICH患者预后的评估价值。方法:回顾性分析106例SICH患者临床病历资料,根据入院30 d内生存情况分为死亡组(31例)及生存组(75例)。比较2组入院时Hemphill脑出血评分、凝血参数[D-二聚体(D-D)、抗凝血酶(AT)、凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、纤维蛋白原(FIB)、凝血酶时间(TT)],采用Pearson相关分析法分析SICH评分与凝血参数的相关性,使用受试者工作特征(ROC)曲线评估SICH评分、凝血参数对SICH患者近期预后的预测价值。结果:2组患者性别、年龄、入院血肿体积、破入脑室发生率、入院血糖及高血压、糖尿病患病史、吸烟史、饮酒史、入院发热情况比较,差异无统计学意义(P均>0.05),但死亡组入院时血压高于生存组,入院72 h血肿体积大于生存组(P均<0.05);死亡组SICH评分、D-D、FIB高于生存组,AT低于生存组(P均<0.05)。经Pearson相关分析,发现SICH患者SICH评分与血D-D、FIB呈显著正相关(r=0.366、0.364,P<0.05),与AT呈显著负相关(r=-0.342,P<0.05)。ROC曲线显示SICH评分、D-D、FIB、AT对SICH患者近期不良预后具有较高预测价值(AUC=0.841、0.886、0.746、0.867,P均<0.05),其截断值分别为2.50分、0.91 mg/L、253.99 mg/L、4.60 g/L,且4项指标联合检测AUC值为0.991,预测价值最高。结论:SICH评分联合D-D、FIB、AT能预测SICH患者近期预后。Objective:To explore the prognostic value of spontaneous intracerebral cerebral hemorrhage(SICH)score combined with coagulation parameters in patients with SICH.Methods:The clinical data of 106 patients with SICH were retrospectively analyzed.According to the survival within 30 d after admission,the patients were divided into death group(31 cases)and survival group(75 cases).The two groups were compared in terms of Hemphill intracerebral hemorrhage score,coagulation parameters[D-dimer(D-D),antithrombin(AT),prothrombin time(PT),activated partial thromboplastin time(APTT),fibrinogen(FIB),thrombin time(TT)]at admission.The Pearson correlation analysis was used to analyze the correlation between SICH score and coagulation parameters in SICH patients,and the receiver operating characteristic(ROC)curve was used to evaluate the predictive value of SICH score and coagulation parameters on the short-term prognosis of SICH patients.Results:There was no significant difference between the two groups in terms of gender,age,volume of hematoma on admission,incidence of ventricular rupture,admission blood glucose and hypertension,history of diabetes,smoking history,drinking history,and fever on admission(P>0.05).The blood pressure in the death group was higher than that in the survival group at admission,and the volume of hematoma at 72 h after admission was larger than that in the survival group(P<0.05).The SICH score,D-D and FIB in the death group were higher than those in the survival group,and AT was lower than that in the survival group(P<0.05).The Pearson correlation analysis showed that the SICH score of SICH patients was significantly positively correlated with blood D-D and FIB(r=0.366,0.364,P<0.05),and negatively correlated with AT(r=-0.342,P<0.05).The ROC curve showed that SICH score,D-D,FIB and AT had high predictive value for the recent adverse prognosis of patients with SICH(AUC=0.841,0.886,0.746,0.867,P<0.05),and their cut-off values were 2.50 points,0.91 mg/L,253.99 mg/L and 4.60 g/L respectively,and the AUC valu

关 键 词：自发性脑出血 脑出血评分 凝血 死亡 预后 

分 类 号：R743.34[医药卫生—神经病学与精神病学]