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急性脑出血早期神经功能恶化与预后相关性研究
Correlation between early neurological deterioration and poor functional outcomes in patients with acute intracerebral hemorrhage
- 第三军医大学学报 2018年40卷第12期 页码：1120-1124
- 作者机构：
400016 重庆，重庆医科大学附属第一医院神经内科
- 作者简介：
[ 谢鹏，E-mail: peng_xie@yahoo.com XIE Peng, E-mail: peng_xie@yahoo.com
- 基金信息：国家自然科学基金青年科学基金(81200899)
DOI：10.16016/j.1000-5404.201711224
中图分类号： R181.32; R741.04; R743.34收稿：2017-11-27，
修回：2018-03-09，
纸质出版：2018-01
- 稿件说明：
移动端阅览
王星辰, 杨文松, 李瑞, 等. 急性脑出血早期神经功能恶化与预后相关性研究[J]. 第三军医大学学报, 2018,40(12):1120-1124.
Xingchen WANG, Wensong YANG, Rui LI, et al. Correlation between early neurological deterioration and poor functional outcomes in patients with acute intracerebral hemorrhage[J]. Journal of Third Military Medical University, 2018, 40(12): 1120-1124.
王星辰, 杨文松, 李瑞, 等. 急性脑出血早期神经功能恶化与预后相关性研究[J]. 第三军医大学学报, 2018,40(12):1120-1124. DOI： 10.16016/j.1000-5404.201711224.
Xingchen WANG, Wensong YANG, Rui LI, et al. Correlation between early neurological deterioration and poor functional outcomes in patients with acute intracerebral hemorrhage[J]. Journal of Third Military Medical University, 2018, 40(12): 1120-1124. DOI： 10.16016/j.1000-5404.201711224.
摘要
目的
2
探讨急性脑出血发生早期神经功能恶化(early neurologic deterioration
END)与预后相关性。
方法
2
选取2016年1月-2017年3月神经内科收治的82例急性脑出血患者，按照其END发生情况分为END阳性组(16例)与END阴性组(66例)，比较两组患者临床资料及90 d功能预后情况，并运用单因素及多因素Logistic回归分析，总结END与不良功能预后发生的独立危险关系。
结果
2
END阳性组的不良远期预后发生率为87.5%，较阴性组(18.2%)差异有统计学意义(
P
<
0.05)。多因素Logistic回归分析结果显示，END发生(
OR
=25.57
95%
CI
：1.53~427.39，
P
=0.024)及入院随机血糖(
OR
=2.11
95%
CI
：1.13~3.91，
P
=0.018)是不良功能预后发生的独立危险因素。
结论
2
急性脑出血发生早期神经功能恶化会导致不良功能预后。
Abstract
Objective
2
To study the correlation between early neurological deterioration (END) and poor functional outcomes in patients with acute intracerebral hemorrhage.
Methods
2
Eighty-two patients with acute cerebral hemorrhage were admitted in our department between January
2016 and March
2017
including 16 with positive findings of END and 66 with negative findings of END. The clinical data and 90-day functional outcomes were compared between the 2 groups
and univariate and multivariate logistic regression analyses were used to assess the correlation between END and poor functional outcomes of the patients.
Results
2
The patients with END had a significantly higher incidence of poor functional outcome than the END-negative patients [87.5%(14/16)
vs
18.2% (12/66)
P
<
0.05
]
. Multivariate logistic regression analysis showed that both END (
OR
=25.57
95%
CI
:1.53~427.39
P
=0.024)and random blood glucose level (
OR
=2.11
95%
CI
:1.13~3.91
P
=0.018)were independent risk factors of poor functional outcome in patients with acute intracerebral hemorrhage.
Conclusion
2
END is associated with poor functional outcomes in patients with acute intracerebral hemorrhage.
关键词
Keywords
references
FALCONE G J, BIFFI A, BROUWERS H B, et al . Predictors of hematoma volume in deep and lobar supratentorial intracerebral hemorrhage[J ] . JAMA Neurol, 2013, 70(8): 988-994. DOI:10.1001/jamaneurol.2013.98.
KWON H M, LEE Y S, BAE H J, et al . Homocysteine as a predictor of early neurological deterioration in acute ischemic stroke[J ] . Stroke, 2014, 45(3): 871-873. DOI:10.1161/STROKEAHA.113.004099.
马国胜, 彭彩丽, 张东, 等.急性重症脑血管病死亡风险的多因素分析及预测[J].中华老年心脑血管病杂志, 2013, 15(5): 540-541.
MA G S, PENG C L, ZHANG D, et al . Multivariate analysis and prediction of death risk in severe acute cerebrovascular disease[J ] . Chin J Geriatr Heart Brain Ves Dis, 2013, 15(5): 540-541.
ARENILLAS J F, ROVIRA A, MOLINA C A, et al . Prediction of early neurological deterioration using diffusion- and perfusion-weighted imaging in hyperacute middle cerebral artery ischemic stroke[J ] . Stroke, 2002, 33(9): 2197-2203. DOI: 10.1161/01.str.0000027861.75884.df.
SAQQUR M, MOLINA C A, SALAM A, et al . Clinical deterioration after intravenous recombinant tissue plasminogen activator treatment: a multicenter transcranial doppler study[J ] . Stroke, 2007(1): 69-74. DOI: 10.1161/01.str.0000251800.01964.f6.
OIS A, MARTINEZ-RODRIGUEZ J E, MUNTEIS E, et al . Steno-occlusive arterial disease and early neurological deterioration in acute ischemic stroke[J ] . Cerebrovasc Dis, 2008, 25(1-2): 151-156. DOI: 10.1159/000113732.
FISHER M, BOGOUSSLAVSKY J. Current review of cerebrovascular disease[M]. Philadelphia: Current Medicine Group, 2001.
D VALOS A, CASTILLO J. Progressing stroke. In: Fisher M, Bogousslavsky J eds. Current review of cerebrovascular disease[J]. Philadelphia: Current Medicine, 1999: 149-160.
SORIMACHI T, FUJⅡ Y. Early neurological change in patients with spontaneous supratentorial intracerebral hemorrhage[J]. J Clin Neurosci, 2010, 17(11): 1367-1371. DOI: 10.1016/j.jocn.2010.02.024.
DU Q, YANG D B, SHEN Y F, et al . Plasma leptin level predicts hematoma growth and early neurological deterioration after acute intracerebral hemorrhage[J ] . Peptides, 2013, 45: 35-39. DOI: 10.1016/j.peptides.2013.04.017.
LEIRA R, D VALOS A, SILVA Y, et al . Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors[J ] . Neurology, 2004, 63(3): 461-467. DOI: 10.1212/01.wnl.0000133204.81153.ac.
RINCON F, LYDEN P, MAYER S A. Relationship between temperature, hematoma growth, and functional outcome after intracerebral hemorrhage[J]. Neurocrit Care, 2013, 18(1): 45-53. DOI: 10.1007/s12028-012-9779-9.
DOWLATSHAHI D, DEMCHUK A M, FLAHERTY M L, et al . Defining hematoma expansion in intracerebral hemorrhage: relationship with patient outcomes[J ] . Neurology, 2011, 76(14): 1238-1244. DOI: 10.1212/WNL.0b013e3182143317.
YAN T, CHOPP M, CHEN J. Experimental animal models and inflammatory cellular changes in cerebral ischemic and hemorrhagic stroke[J]. Neurosci Bull, 2015, 31(6): 717-734. DOI: 10.1007/s12264-015-1567-z.
ANTUNES A P, SCHIEFECKER A J, BEE R R, et al . Higher brain extracellular potassium is associated with brain metabolic distress and poor outcome after aneurysmal subarachnoid hemorrhage[J ] . Crit Care,2014, 18(3): R119. DOI: 10.1186/cc13916.
胡登科, 刘利生, 刘晓海, 等.老年急性丘脑出血患者血糖水平与预后的临床分析[J].中华老年心脑血管病杂志, 2013, 15(12): 1305-1306.
HU D K, LIU L S, LIU X H, et al . Effect of blood glucose level on prognosis of elderly acute thalamic hemorrhage patients[J ] . Chin J Geriatr Heart Brain Ves Dis, 2013, 15(12): 1305-1306.
STRAHLE J, GARTON HJ, MAHER CO, et al . Mechanisms of hydrocephalus after neonatal and adult intraventricular hemorrhage[J ] . Transl Stroke Res, 2012, 3(Suppl 1): 25-38. DOI: 10.1007/s12975-012-0182-9.
ZINKSTOK S M, BEENEN L F, MAJOIE C B, et al . Early deterioration after thrombolysis plus aspirin in acute stroke: a post hoc analysis of the antiplatelet therapy in combination with recombinant t-PA thrombolysis in ischemic stroke trial[J ] . Stroke, 2014, 45(10): 3080-3082. DOI: 10.1161/STROKEAHA.114.006268.
MANNING L, HIRAKAWA Y, ARIMA H, et al . Blood pressure variability and outcome after acute intracerebral haemorrhage: a post-hoc analysis of INTERACT2, a randomised controlled trial[J ] . Lan cet Neurol, 2014, 13(4): 364-373. DOI: 10.1016/S1474-4422(14)70018-3.
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