急性脑出血伴高血压患者90d死亡相关因素分析

发布时间：2018-02-28 22:17

  本文关键词： 脑出血 高血压 死亡 危险因素　出处：《中华高血压杂志》2016年09期 　论文类型：期刊论文

【摘要】：目的探索急性脑出血伴高血压患者90d死亡的相关因素。方法收集发病6h以内的急性脑出血伴高血压患者168例,入院时CT计算血肿大小;1周内行神经功能缺损程度评分;应用电子血压计测量1周内不同时间段(到院急诊、入院当时、入院后24h内每隔6h及入院24h后2次/d)的血压,随访90d后用改良Rankin量表评分(mRS)评估神经功能恢复状况,分析死亡的相关因素。结果 168例患者90d死亡20例(11.9%)。其中1例在24h内死亡,占死亡人数的5%,8例在1周内死亡,占40%。与存活者比较,死亡者年龄较大[(76.2±14.2)比(63.5±13.2)岁,P0.01],入院后30 min[(176.5±14.5)比(160.1±20.0)mm Hg]、45 min[(166.3±13.4)比(156.0±18.6)mm Hg]及6h血压[(150.6±18.5)比(140.0±18.5)mm Hg]较高(均P0.05),血肿体积较大[91.7(25.0~133.7)比32.3(13.8~49.7)mL,P0.05]。多因素Logistic回归分析发现,年龄、入院后30min血压及血肿体积是死亡的独立危险因素。结论高龄、血肿体积大及入院后30min血压控制不佳,是急性脑出血伴高血压患者死亡的重要危险因素。
[Abstract]:Objective to explore the related factors of death in patients with acute intracerebral hemorrhage with hypertension in 90 days. Methods 168 patients with acute cerebral hemorrhage with hypertension within 6 hours were collected. The blood pressure was measured by electronic sphygmomanometer at different time periods within 1 week (emergency, at the time of admission, every 6 hours within 24 hours after admission and twice a day after admission). After 90 days of follow-up, the recovery of nerve function was evaluated by modified Rankin scale score (mRSs). Results among 168 patients died in 90 days, 20 cases died 11.9%. One case died within 24 hours, accounting for 58 cases died within one week, accounting for 40%, compared with the survivors. The dead patients were older [76.2 卤14.2vs 63.5 卤13.2mHg], 30 min after admission [176.5 卤14.5) vs 160.1 卤20.0mm Hg] 45 min [166.3 卤13.4) vs 156.0 卤18.6mm Hg] and 6h blood pressure (150.6 卤18.5mm Hg vs 140.0 卤18.5mm Hg) were higher (all P0.05, hematoma volume was larger [91.725.0 + 133.7) vs 32.313.849.7mLHg]. Multiple factor Logistic regression analysis showed that the blood pressure was higher than 140.0 卤18.5mHg (all P0.05mHg), and the hematoma volume was larger (91.725.0 卤133.7mHg) than 32.313.849.7mLHg (P0.05). Conclusion Old age, large hematoma volume and poor blood pressure control at 30 min after admission are important risk factors for death of patients with acute intracerebral hemorrhage and hypertension.
【作者单位】： 南京中医药大学附属徐州中心医院神经内科徐州市中心医院东南大学医学院附属徐州医院徐州医科大学徐州临床学院;徐州医科大学;
【基金】：江苏省徐州市科技计划项目(XF10C095,KC14SH027)
【分类号】：R544.1;R743.34

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