摘要
目的分析出血性脑卒中患者30 d病死的相关危险因素;比较o ICH、NICH、MICH量表预测30 d病死率的精确性及判断预后的价值。方法收集152例出血性脑卒中患者临床资料及随访预后;单因素分析中有统计学意义的变量行Logistic多元回归分析;用诊断性实验中Youden指数、ROC曲线下面积来评估量表的预测价值。结果年龄、脉压差、冠心病病史、静脉血糖、白细胞计数、血肿体积、IVH、GCS、有无中线移位在单因素分析中差异有统计学意义（P〈0.05）;年龄〉80岁、GCS（3~4分）、静脉血糖较高在Logistic多元回归分析中差异有统计学意义（P〈0.05）。o ICH在灵敏度、特异度方面优于NICH、MICH。结论年龄〉80岁、GCS（3~4分）、静脉血糖较高是预测出血性脑卒中短期内病死的独立危险因素。o ICH在预测出血性脑卒中30 d病死率方面可能优于MICH和NICH。
Objective To determine the risk factors for predicting the 30-day mortality of spontaneous intracerebral hemorrhage（ ICH） and investigate the prognostic values of this new grading scale with 3 wellknown grading scores of ICH（ original ICH score,modified ICH score,and new ICH score）. Methods A total of 152 ICH patients admitted in the departments of neurology and neurosurgery of the Second Affiliated Hospital of Chongqing Medical University from December 2011 to October 2013 were recruited in this study.Their clinical data,follow-up and prognostic data were collected. All the prognostic factors were analyzed with univariate analysis,and those obtained significant factors were further analyzed with logistic multiple regression analysis. Youden＇index and the area under the receiver operating characteristic（ ROC） curve were used to evaluate the predictive value of the scales. Results There were 9 variables,including age,pulse pressure,history of coronary heart disease,venous blood glucose,white blood cell count,ICH volume,intraventricular haemorrhage（ IVH）,Glasgow coma scale（ GCS） score,and midline shift（ P〈0. 05）. Logistic regression analysis showed that aged 〉80,lower GCS scores（ 3 ~ 4） and hyperglycaemia were remarkable in the prediction（ P〈0. 05）. The original ICH score was slightly better than the other 2 scores in the sensitivity and specificity. Conclusion Aged 〉80,lower GCS scores（ 3 ~ 4） and hyperglycaemia are independent risk factors for predicting 30-day mortality in ICH patients. The original ICH score is superior to the new ICH score and modified ICH score in prediction of 30-day intracerebral hemorrhage.
出处
《第三军医大学学报》
CAS
CSCD
北大核心
2016年第1期79-84,共6页
Journal of Third Military Medical University
关键词
出血性脑卒中
预后
病死率
危险因素
评估量表
intracerebral hemorrhage
prognosis
mortality
risk factors
clinical grading scale
