糖化血红蛋白与幕上脑出血急性期最终血肿体积的相关性分析

发布时间：2018-06-24 17:30

本文选题：糖化血红蛋白 + 脑出血　；参考：《福建医科大学》2013年硕士论文

【摘要】：目的：探讨糖化血红蛋白（HbA1c）与幕上脑出血急性期最终血肿体积的关系；为脑出血急性期血糖调控的临床研究提供依据。方法：对2009.1.1～2012.12.31期间于福建医科大学附属第一医院神经内科入院、发病至入院时间小于7天、行HbA1c检查、经颅脑CT检查确诊为幕上脑出血的急性期患者的临床资料进行回顾性分析。收集患者的性别、年龄、既往病史、首次空腹血糖、HbA1c等临床资料，并采用多田公式计算的最终（最大）血肿体积。采用SPSS（18.0）统计软件，对纳入的134例幕上脑出血急性期患者的相关指标与最终血肿体积的关系先后进行单因素和多因素分析，其中多因素分析采用二元logistic回归，逐步向前法，P＜0.05。结果：共纳入患者134例，年龄范围（37～91）岁，平均（61.26±11.91）岁；男性94例，女性40例；有高血压病史89例，无高血压病史45例；有糖尿病病史23例，无糖尿病病史111例；基底节区出血97例，丘脑出血27例；脑叶出血10例；HbA1c范围（4.6～13.2）%；空腹血糖范围（3.89～17.75）mmol/L；最终血肿体积范围（0.30～56.10）ml。先对可能的相关因素进行单因素分析（Manne Whitney U检验及Kruskal-Wallis H检验），结果显示HbA1c（P=0.009）、年龄（P=0.007)、糖尿病史（P=0.049）、血肿部位（P=0.003）对最终血肿体积的影响有统计学意义。再对单因素分析中检出的具有统计学意义的因素进行二元logistic逐步回归（向前逐步法，，P＜0.05），结果显示：①HbA1c(P=0.011)、年龄（P=0.013）是影响最终血肿体积的相关因素；②HbA1c较小，出现较大血肿体积的风险降低(OR=0.271)；③年龄较小，出现较大血肿体积的风险降低(OR=0.404)。结论：1.HbA1c是幕上脑出血急性期最终血肿体积的独立危险因素；2.年龄是幕上脑出血急性期最终血肿体积的独立危险因素；3.有必要进一步开展大样本随机对照试验评价脑出血急性期最终血肿体积的影响因素及干预治疗。
[Abstract]:Objective: to investigate the relationship between HbA1c and final hematoma volume in acute stage of supratentorial intracerebral hemorrhage, and to provide basis for clinical study of blood glucose regulation in acute stage of intracerebral hemorrhage. Methods: HbA1c was performed on patients admitted to Department of Neurology, the first affiliated Hospital of Fujian Medical University, during the period of January 1, 2009 to December 31, 2012.The time from onset to admission was less than 7 days. The clinical data of patients with supratentorial intracerebral hemorrhage diagnosed by craniocerebral CT were retrospectively analyzed. The clinical data such as sex, age, past medical history, first fasting blood glucose and HbA1c were collected, and the final (maximum) hematoma volume was calculated by using the Duotian formula. SPSS (18.0) statistical software was used to analyze the relationship between the related indexes and final hematoma volume in 134 patients with supratentorial intracerebral hemorrhage (SCH). The multivariate logistic regression was used for multivariate analysis, and the stepwise forward method was used (P < 0.05). Results: a total of 134 patients (mean 61.26 卤11.91 years old) were enrolled in the study, 94 males and 40 females, 89 patients with hypertension history, 45 patients with no hypertension history, 23 patients with diabetes history and 111 patients with no history of diabetes mellitus. There were 97 cases of basal ganglia hemorrhage, 27 cases of thalamic hemorrhage, 10 cases of lobar hemorrhage with HbA1c range (4.6 卤13.2), (3.89 卤17.75) mmol / L of fasting blood glucose and (0.30 卤56.10) ml of final hematoma volume. Univariate analysis (Manne Whitney U test and Kruskal-Wallis H test) showed that HbA1c (P0. 009), age (P0. 007), diabetes history (P0. 049), hematoma location (P0. 003) had a significant effect on the final hematoma volume. The results showed that 1: 1HbA1c (P0. 011) and age (P0. 013) were the relative factors affecting the final hematoma volume. The risk of larger hematoma volume decreased (ORO 0.271) and the risk of larger hematoma volume decreased (ORO 0.404). Conclusion 1. HbA1c is an independent risk factor for final hematoma volume in acute supratentorial intracerebral hemorrhage. Age is an independent risk factor for final hematoma volume in acute supratentorial intracerebral hemorrhage. It is necessary to further develop a large sample randomized controlled trial to evaluate the influencing factors of final hematoma volume in acute stage of intracerebral hemorrhage and its intervention therapy.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R743.34

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