血清CO_(2)、K^(+)、Na^(+)、Cl-及阴离子间隙在脑干出血患者意识障碍转归过程中的临床意义  

Monitoring and Clinical Significance of Serum CO_(2),K^(+),Na^(+),Cl^(-)and Other Components in the Process of Consciousness Disorders in Patients with Brainstem Hemorrhage

作　　者：马雅文[1] 王曼[1] 孙洋 MA Yawen;WANG Man;SUN Yang(Department of Medical Laboratory,the First Central Hospital of Baoding City,Baoding 071000,China)

机构地区：[1]河北省保定市第一中心医院医学检验科,保定071000

出　　处：《宁夏医科大学学报》2025年第2期161-165,共5页Journal of Ningxia Medical University

摘　　要：目的探讨血清二氧化碳(CO_(2))、钾离子(K^(+))、钠离子(Na^(+))、氯离子(Cl^(-))及阴离子间隙(AG)在不同意识障碍脑干出血患者中的含量变化特点及其与患者意识障碍转归的相关性。方法回顾性分析2021年1月至2023年1月间收治的118例脑干出血患者临床资料,根据格拉斯哥昏迷量表(GCS)评分将其分为意识障碍组(36例)、无意识障碍组(52例)及意识障碍好转组(30例)。比较各组患者血CO_(2)、K^(+)、Na^(+)、Cl^(-)及AG的水平,波动幅度及异常率,采用Pearson相关性系数分析各指标异常频次与意识障碍转归的相关性。结果无意识障碍组患者血清中Cl^(-)、AG水平低于意识障碍好转组与意识障碍组,意识障碍好转组血清中Cl^(-)、AG水平均低于意识障碍组(P均<0.05);但各组患者血清中CO_(2)、K^(+)、Na^(+)水平比较,差异均无统计学意义(P均>0.05);无意识障碍组血清中CO_(2)、K^(+)、Na^(+)、Cl^(-)及AG波动幅度均低于意识障碍好转组与意识障碍组(P均<0.05),意识障碍好转组血清中CO_(2)、Na^(+)、Cl^(-)及AG波动幅度均低于意识障碍组(P均<0.05),但意识障碍好转组与意识障碍组血清K^(+)波动幅度比较差异无统计学意义(P>0.05);无意识障碍组血清中CO_(2)、K^(+)、Na^(+)、Cl^(-)、AG异常率均低于意识障碍好转组与意识障碍组,意识障碍好转组血清中CO_(2)、K^(+)、Na^(+)、Cl^(-)、AG异常率均低于意识障碍组(P均<0.05);Pearson相关系数分析显示,血清中CO_(2)、K^(+)、Na^(+)、Cl^(-)、AG指标异常频次与GCS评分均呈负相关(r值分别为:-0.587、-0.482、-0.509、-0.596、-0.546,P均<0.05)。结论脑干出血患者意识障碍程度及转归与电解质紊乱密切相关,检测体内电解质变化对于患者转归具有一定指导价值。Objective To explore the characteristics of content changes of electrolyte components such as serum carbon dioxide(CO_(2)),potassium ions(K^(+)),sodium ions(Na^(+)),chloride ions(Cl^(-))and anion gap(AG)in patients with brainstem hemorrhage with different consciousness disorders and their correlation with the prognosis of consciousness disorders in patients.Methods A retrospective analysis was conducted on the clinical data of 118 patients with brainstem hemorrhage admitted from January 2021 to January 2023.According to the Glasgow coma scale(GCS)score,they were divided into consciousness disorder group(36 cases),unconsciousness disorder group(52 cases),and consciousness disorder improvement group(30 cases).The content levels,fluctuation amplitude,and abnormal rate of blood CO_(2),K^(+),Na^(+),Cl^(-)and AG in each group of patients were compared,and Pearson correlation coefficient was used to analyze the correlation between the abnormal frequency of each indicator and the prognosis of consciousness disorders.Results The blood Cl^(-)and AG levels in the unconscious disorder group were lower than those in the consciousness disorder improvement group and consciousness disorder group,while the blood Cl^(-)and AG levels in the consciousness disorder improvement group were lower than those in the consciousness disorder group(P all<0.05).However,there was no statistically significant difference in the levels of CO_(2),K^(+)and Na^(+)in the blood of patients in each group(P all>0.05).The fluctuation amplitude of blood CO_(2),K^(+),Na^(+),Cl^(-)and AG in the unconscious disorder group was lower than that in the consciousness disorder improvement group and consciousness disorder group(P all<0.05).The fluctuation amplitude of blood CO_(2),Na^(+),Cl^(-)and AG in the consciousness disorder improvement group was lower than that in the consciousness disorder group(P all<0.05),but there was no statistically significant difference in the fluctuation amplitude of blood K^(+)between the consciousness disorder improvement group and

关 键 词：电解质紊乱 脑干出血 意识障碍 转归 

分 类 号：R446.1[医药卫生—诊断学]