文章摘要
梁翠丹,欧阳范献.海南某院高血压性脑出血预测指标的探索研究[J].安徽医药,待发表.
海南某院高血压性脑出血预测指标的探索研究
投稿时间:2021-11-24  录用日期:2021-12-28
DOI:
中文关键词: 高血压性脑出血  危险因素  预测
英文关键词: 
基金项目:2020年海南省普通高等学校研究生创新科研课题(Hys2020-380);2016年海南省重大科技计划项目(编号:ZDKJ2016008),
作者单位地址
梁翠丹 海南医学院 海南省海口市龙华区城西镇学院路3号海南医学院
欧阳范献 海南医学院第二附属医院 
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中文摘要:
      目的 探索高血压性脑出血(HICH)的危险因素及预测指标,为HICH的防治提供依据。方法 以2013.1.1—2020.6.30在海南某三甲医院住院的226例HICH患者作为观察组,对照组是361例无HICH的高血压患者。收集研究对象的脑梗死史,血压、血脂的指标及血清胱抑素(CysC)等临床、检验指标,同时HICH患者在发生HICH前的指标亦收集。进行两组间和自身发病前、后指标的差异分析,用多因素logistic回归分析和ROC曲线绘制来分析其与HICH相关性及预测作用。结果 单因素分析结果显示HICH组收缩压[SBP,171(150,194)mmHg比141(129,157)mmHg]、舒张压[SDP,95(86,105)mmHg比80(73,90)mmHg]、葡萄糖[GLU,7.44(5.94,9.73)mmol/L比5.42(4.84,6.65)mmol/L]、中性粒细胞绝对数[NEUT,8.64(5.87,12.02)×109mmol/L比4.07(3.09,5.49)×109mmol/L]、白细胞(WBC)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(ApoA1)高于对照组(P<0.05)。低密度脂蛋白胆固醇(LDL-C)、脂蛋白a(Lpa)在两组间无差异(P>0.05)。多因素logistic回归分析结显示有脑梗死史,高血压病程、SBP、总胆固醇(TC)、GLU、NEUT升高,淋巴细胞计数(LYM)降低,可能增加HICH发生的风险(P<0.05)。且NEUT、SBP、GLU、LYM的AUC分别为0.822、0.800、0.742、0.710(P<0.05),预测HICH的临界值分别为5.64×109mmol/L、161mmHg、6.35mmol/L、1.23×109mmol/L。结论 有脑梗死史、高血压病程、SBP、GLU、TC、NEUT,LYM与HICH密切相关。NEUT、SBP、GLU、LYM对HICH有一定的预测价值。
英文摘要:
      Objective To explore the risk factors and predictors of hypertensive intracerebral hemorrhage (HICH). Methods 226 patients with HICH who were hospitalized in a tertiary hospital in Hainan from January 1, 2013 to June 30, 2020 were taken as the observation group, and the control group was 361 patients with hypertension without HICH. Their blood pressure, blood lipid, serum cystatin(CysC) and so on, were collected from medical records. The indicators of HICH patients before the occurrence of HICH also need to be collected. The differences between the two groups and before and after the onset of the HICH were analyzed by t test, Chi-square test, willcox test. Multivariate logistic regression analysis and ROC curve were used to analyze its correlation with HICH and its predictive effect. Results Univariate analysis showed that the systolic blood pressure[SBP,171(150,194)mmHg min vs.141(129,157)mmHg], diastolic blood pressure[SDP,95(86,105)mmHg min vs.80(73,90)mmHg], glucose[GLU,7.44(5.94,9.73)mmol/L min vs.5.42(4.84,6.65)mmol/L], neutrophil count[NEUT,8.64(5.87, 12.02)×109mmol/L min vs.4.07(3.09,5.49)×109mmol/L], white blood cell count(WBC), apolipoprotein A1(ApoA1), and high-density lipoprotein cholesterol(HDL-C) in the HICH group were higher than those in the control group (P<0.05). There was no difference in low-density lipoprotein cholesterol(LDL-C) and lipoprotein a(Lpa) between the two groups (P>0.05). Multivariate 1ogistic regression analysis indicates that History of cerebral infarction, the course of hypertension, systolic blood pressure, GLU, total cholesterol(TC), and NEUT increased, while lymphocyte count(LYM) decreased,which may increase the risk of HICH (P<0.05). The results of ROC curves of NEUT, SBP, GLU and LYM for prediction of HICH showed that AUC were 0.822, 0.799, 0.742 and 0.710, respectively. According to the principle of Youden index,the cut off value of NEUT, SBP, GLU and LYM to predict the occurrence risk of HICH were 5.64×109mmol/L,161mmHg,6.35mmol/L and 1.23×109mmol/L. Conclusion History of cerebral infarction, course of hypertension, SBP, GLU, TC,NEUT and LYM were associated with the risk of HICH.NEUT, SBP, GLU and LYM may predict the occurrence of HICH.
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