摘要
目的探讨老年蛛网膜下腔出血(SAH)患者发生脑血管痉挛(CVS)的相关危险因素。方法选择SAH患者62例,以是否发生CVS,将患者分为CVS组(27例)和非CVS组(35例),比较2组基线资料,并对住院前和住院期间发生CVS的相关因素进行logistic分析和COX分析。结果与非CVS组比较,CVS组患者吸烟、糖尿病、高血压年限及发热时间更长(P<0.05,P<0.01)。WBC计数明显增高(OR=1.515,95% CI:1.045～1.247,P=0.028)是CVS预测因素;吸烟(RR=1.044,95% CI:1.010～1.078,P=0.010)和高血压(RR=1.092,95% CI:1.025～1.163,P=0.006)是住院期间CVS独立危险因素;适当延长住院时间可以降低CVS的发生(RR=0.931,95% CI:0.878～0.987,P=0.016)。由于样本量小,糖尿病是住院前和住院期间发生CVS的低概率危险因素。结论吸烟、高血压、入院时WBC计数增高的老年SAH患者CVS发生风险显著增加;适当延长住院时间,可以降低CVS风险。
Objective To investigate relevant risk factors for cerebral vasospasm（CVS） in elderly patients with subarachnoid hemorrhage（SAH） in order to provide the clinical basis for early pre- diction and treatment. Methods Sixty-two SAH patients were selected and divided into CVS group（27 patients） and non-CVS group（35 patients）. Baseline data were compared between the 2 groups. The relevant risk factors for CVS before and after admission were analyzed by multivari- ate logistic analysis and COX analysis. Results Compare with non-CVS group,the proportions of smoking,history of diabetes and hypertension were significantly higher in CVS group （P 0.05）. Increase in leukocyte count （OR = 1. 515,95% CI ： 1. 045 1. 247, P = 0. 028） was the predicting factor for CVS. Smoking （RR = 1.044,95% CI ：1.010--1.078, P = 0.010） and hy pertension （RR = 1. 092,95% CI ：1. 025--1. 163, P = 0. 006） were independent risk factors for CVS after admission. Appropriate extension of length of hospital stay could reduce the incidence of CVS （RR = 0. 931,95% CI ：0. 878--0. 987, P = 0. 016）. Conclusions CVS risk increased sig- nificantly in SAH patients with long-term smoking history, hypertension, and increase in leuko- cyte count on admission. Appropriate extension of length of hospital stay can reduce the incidence of CVS.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2010年第5期444-447,共4页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
关键词
蛛网膜下腔出血
血管痉挛
颅内
吸烟
高血压
糖尿病
危险因素
subarachnoid hemorrhage
vasospasm, intracranial
smoking
hypertension
diabetes mellitus
risk factors
