文章摘要
张 著,黄广龙,林少华,林志颖,欧阳玉凤.入院时血清钙水平与高血压性脑出血血肿体积、神经功能及预后的关系研究[J].,2021,(24):4690-4693
入院时血清钙水平与高血压性脑出血血肿体积、神经功能及预后的关系研究
Relationship Study between Serum Calcium Level at Admission and Hematoma Volume, Neurological Function and Prognosis of Hypertensive Intracerebral Hemorrhage
投稿时间:2021-05-23  修订日期:2021-06-17
DOI:10.13241/j.cnki.pmb.2021.24.018
中文关键词: 高血压性脑出血  血清钙  血肿  神经功能  预后
英文关键词: Hypertensive intracerebral hemorrhage  Serum calcium  Hematoma  Nerve function  Prognosis
基金项目:广东省科技计划项目(2016A040403053)
作者单位E-mail
张 著 南方医科大学南方医院神经外科 广东 广州 510515中山市人民医院神经外科 广东 中山 528400 zhu07500760@163.com 
黄广龙 南方医科大学南方医院神经外科 广东 广州 510515  
林少华 中山市人民医院神经外科 广东 中山 528400  
林志颖 南方医科大学南方医院神经外科 广东 广州 510515  
欧阳玉凤 中山市人民医院神经外科 广东 中山 528400  
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中文摘要:
      摘要 目的:探讨入院时血清钙水平与高血压性脑出血血肿体积、神经功能及预后的关系。方法:选择2018年9月-2020年4月我院收治的高血压性脑出血患者102例,根据患者入院时血清钙水平将其分为低血钙组(血清钙<2.1 mmol/L, n=34)、正常血钙组(2.1 mol/L≤血清钙≤2.7 mmol/L, n=39)和高血钙组(血清钙>2.7 mmol/L, n=29),比较各组性别、血肿体积、入院美国国立卫生研究院卒中量表(NIHSS)评分等临床资料。所有患者随访1年,观察患者格拉斯哥预后量表(GOS)评分,根据患者预后情况将患者分为预后良好组(n=84)和预后不良组(n=18),比较两组血清钙、血肿体积、入院NIHSS评分、GOS评分。应用受试者工作特征(ROC)曲线分析血清钙水平对患者预后的预测价值。结果:三组血肿体积、入院NIHSS评分、GOS评分、1年病死率、1年再出血率、总预后不良率比较有统计学差异(P<0.05)。预后不良组血清钙水平、GOS评分显著低于预后良好组,血肿体积、入院NIHSS评分显著高于预后良好组(P<0.05)。Pearson相关性分析显示:高血压性脑出血患者入院时血清钙水平与脑出血血肿体积、入院NIHSS评分呈负相关,与GOS评分呈正相关(P<0.05)。ROC曲线分析显示入院时血清钙预测高血压脑出血不良预后的曲线下面积为0.129(95%CI:0.073~0.179)。结论:高血压性脑出血患者入院时血清钙水平与血肿体积、神经功能及预后存在一定关联,且入院时血清钙对高血压性脑出血不良预后具有一定预测价值。
英文摘要:
      ABSTRACT Objective: To investigate the relationship between the serum calcium level at admission and hematoma volume, neurological function and prognosis of hypertensive intracerebral hemorrhage. Methods: 102 patients with hypertensive intracerebral hemorrhage who were admitted to our hospital from September 2018 to April 2020 were selected, which were divided into low blood calcium group (serum calcium<2.1 mmol/L, n=34), normal blood calcium group (2.1 mol/L≤serum calcium≤2.7 mmol/L, n=39) and high blood calcium group (serum calcium > 2.7 mmol/L, n=29) according to their serum calcium level at admission. The gender, hematoma volume, National Institutes of Health Stroke Scale (NIHSS) score at admission and other clinical data of each group were compared. All patients were followed up for 1 year, the Glasgow Outcome Scale (GOS) score of patients were observed. According to the prognosis of patients, the patients were divided into good prognosis group (n=84) and poor prognosis group (n=18). Serum calcium, hematoma volume, NIHSS score at admission and GOS score were compared between the two groups. Receiver operating characteristic (ROC) curve was used to analyze the predictive value of serum calcium level in patients' prognosis. Results: There were significant differences in hematoma volume, NIHSS score at admission, GOS score, 1-year fatality rate, 1-year rebleeding rate and overall poor prognosis rate in the three groups (P<0.05). The serum calcium level and GOS score in the poor prognosis group were significantly lower than those in the good prognosis group, and the hematoma volume and NIHSS score at admission were significantly higher than those in the good prognosis group (P<0.05). Pearson correlation analysis showed that the serum calcium level at admission of patients with hypertensive intracerebral hemorrhage was negatively correlated with hematoma volume, NIHSS score at admission, while positively correlated with GOS score (P<0.05). ROC curve analysis showed that the area under the curve for serum calcium at admission to predict adverse prognosis of hypertensive intracerebral hemorrhage was 0.129 (95%CI: 0.073-0.179). Conclusion: Serum calcium level at admission is correlated with hematoma volume, neurological function and prognosis in patients with hypertensive intracerebral hemorrhage, and serum calcium at admission has a certain predictive value for the poor prognosis of hypertensive intracerebral hemorrhage.
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