本文關鍵詞： 腦出血 高血壓 死亡 危險因素　出處：《中華高血壓雜志》2016年09期 　論文類型：期刊論文

【摘要】：目的探索急性腦出血伴高血壓患者90d死亡的相關因素。方法收集發(fā)病6h以內的急性腦出血伴高血壓患者168例,入院時CT計算血腫大小;1周內行神經(jīng)功能缺損程度評分;應用電子血壓計測量1周內不同時間段(到院急診、入院當時、入院后24h內每隔6h及入院24h后2次/d)的血壓,隨訪90d后用改良Rankin量表評分(mRS)評估神經(jīng)功能恢復狀況,分析死亡的相關因素。結果 168例患者90d死亡20例(11.9%)。其中1例在24h內死亡,占死亡人數(shù)的5%,8例在1周內死亡,占40%。與存活者比較,死亡者年齡較大[(76.2±14.2)比(63.5±13.2)歲,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血壓[(150.6±18.5)比(140.0±18.5)mm Hg]較高(均P0.05),血腫體積較大[91.7(25.0~133.7)比32.3(13.8~49.7)mL,P0.05]。多因素Logistic回歸分析發(fā)現(xiàn),年齡、入院后30min血壓及血腫體積是死亡的獨立危險因素。結論高齡、血腫體積大及入院后30min血壓控制不佳,是急性腦出血伴高血壓患者死亡的重要危險因素。
[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 鹵14.2vs 63.5 鹵13.2mHg], 30 min after admission [176.5 鹵14.5) vs 160.1 鹵20.0mm Hg] 45 min [166.3 鹵13.4) vs 156.0 鹵18.6mm Hg] and 6h blood pressure (150.6 鹵18.5mm Hg vs 140.0 鹵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 鹵18.5mHg (all P0.05mHg), and the hematoma volume was larger (91.725.0 鹵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.
【作者單位】： 南京中醫(yī)藥大學附屬徐州中心醫(yī)院神經(jīng)內科徐州市中心醫(yī)院東南大學醫(yī)學院附屬徐州醫(yī)院徐州醫(yī)科大學徐州臨床學院;徐州醫(yī)科大學;
【基金】：江蘇省徐州市科技計劃項目(XF10C095,KC14SH027)
【分類號】：R544.1;R743.34

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