發(fā)布時(shí)間：2018-06-24 17:30

  本文選題：糖化血紅蛋白 + 腦出血　； 參考：《福建醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：探討糖化血紅蛋白（HbA1c）與幕上腦出血急性期最終血腫體積的關(guān)系；為腦出血急性期血糖調(diào)控的臨床研究提供依據(jù)。 方法：對(duì)2009.1.1～2012.12.31期間于福建醫(yī)科大學(xué)附屬第一醫(yī)院神經(jīng)內(nèi)科入院、發(fā)病至入院時(shí)間小于7天、行HbA1c檢查、經(jīng)顱腦CT檢查確診為幕上腦出血的急性期患者的臨床資料進(jìn)行回顧性分析。收集患者的性別、年齡、既往病史、首次空腹血糖、HbA1c等臨床資料，并采用多田公式計(jì)算的最終（最大）血腫體積。采用SPSS（18.0）統(tǒng)計(jì)軟件，對(duì)納入的134例幕上腦出血急性期患者的相關(guān)指標(biāo)與最終血腫體積的關(guān)系先后進(jìn)行單因素和多因素分析，其中多因素分析采用二元logistic回歸，逐步向前法，P＜0.05。結(jié)果：共納入患者134例，年齡范圍（37～91）歲，平均（61.26±11.91）歲；男性94例，女性40例；有高血壓病史89例，無(wú)高血壓病史45例；有糖尿病病史23例，無(wú)糖尿病病史111例；基底節(jié)區(qū)出血97例，丘腦出血27例；腦葉出血10例；HbA1c范圍（4.6～13.2）%；空腹血糖范圍（3.89～17.75）mmol/L；最終血腫體積范圍（0.30～56.10）ml。 先對(duì)可能的相關(guān)因素進(jìn)行單因素分析（Manne Whitney U檢驗(yàn)及Kruskal-Wallis H檢驗(yàn)），結(jié)果顯示HbA1c（P=0.009）、年齡（P=0.007)、糖尿病史（P=0.049）、血腫部位（P=0.003）對(duì)最終血腫體積的影響有統(tǒng)計(jì)學(xué)意義。 再對(duì)單因素分析中檢出的具有統(tǒng)計(jì)學(xué)意義的因素進(jìn)行二元logistic逐步回歸（向前逐步法，，P＜0.05），結(jié)果顯示：①HbA1c(P=0.011)、年齡（P=0.013）是影響最終血腫體積的相關(guān)因素；②HbA1c較小，出現(xiàn)較大血腫體積的風(fēng)險(xiǎn)降低(OR=0.271)；③年齡較小，出現(xiàn)較大血腫體積的風(fēng)險(xiǎn)降低(OR=0.404)。結(jié)論：1.HbA1c是幕上腦出血急性期最終血腫體積的獨(dú)立危險(xiǎn)因素；2.年齡是幕上腦出血急性期最終血腫體積的獨(dú)立危險(xiǎn)因素；3.有必要進(jìn)一步開(kāi)展大樣本隨機(jī)對(duì)照試驗(yàn)評(píng)價(jià)腦出血急性期最終血腫體積的影響因素及干預(yù)治療。
[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 鹵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 鹵13.2), (3.89 鹵17.75) mmol / L of fasting blood glucose and (0.30 鹵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.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2013
【分類(lèi)號(hào)】：R743.34

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相關(guān)期刊論文 前2條

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本文編號(hào)：2062381