本文選題：蛛網(wǎng)膜下腔出血 + 血清白蛋白��； 參考：《中國腦血管病雜志》2017年01期

【摘要】：目的探討動脈瘤性蛛網(wǎng)膜下腔出血(a SAH)患者發(fā)生遲發(fā)性腦缺血(DCI)的危險因素。方法回顧性連續(xù)納入2015年1月至2016年4月南京軍區(qū)南京總醫(yī)院神經(jīng)外科收治的接受血管內(nèi)介入治療的a SAH患者106例,根據(jù)是否發(fā)生DCI,將患者分為DCI組(34例)與無DCI組(72例)。收集患者一般資料,包括性別、年齡、Hunt-Hess分級、改良Fisher分級、世界神經(jīng)外科聯(lián)盟(WFNS)分級、急性腦水腫、早期(出血1~3 d)低白蛋白血癥、低血紅蛋白血癥等。進行單因素和多因素Logistic回歸分析DCI發(fā)生的危險因素。結(jié)果 DCI發(fā)生率為32.1%(34/106)。DCI組Hunt-Hess分級≥Ⅲ級、改良Fisher分級≥Ⅲ級、WFNS分級≥Ⅳ級、急性腦水腫、低血紅蛋白血癥及低白蛋白血癥的發(fā)生率均高于無DCI組,組間差異均有統(tǒng)計學(xué)意義(均P0.05);性別、年齡≥55歲、高血壓病、糖尿病、低鈉血癥比例的組間差異均無統(tǒng)計學(xué)意義(均P0.05)。將單因素分析中Hunt-Hess分級≥Ⅲ級、改良Fisher分級≥Ⅲ級、入院WFNS分級≥Ⅳ級、低白蛋白血癥作為自變量進行多因素分析,結(jié)果顯示,入院WFNS分級≥Ⅳ級(OR=8.02,95%CI:2.41~26.70)、改良Fisher分級≥Ⅲ級(OR=4.44,95%CI:1.38~14.32)、1~3 d低白蛋白血癥(OR=5.42,95%CI:1.40~20.76)是a SAH患者發(fā)生DCI的獨立危險因素(均P0.05)。而Hunt-Hess分級≥Ⅲ級不是a SAH患者發(fā)生DCI的危險因素(OR=1.86,95%CI:0.39~8.88,P0.05)。結(jié)論 a SAH后低白蛋白血癥、入院WFNS分級≥Ⅳ級、改良Fisher分級≥Ⅲ級是患者發(fā)生DCI的獨立危險因素,臨床診治過程中應(yīng)引起高度重視。
[Abstract]:Objective to investigate the risk factors of delayed cerebral ischemia (DCI) in patients with aneurysm subarachnoid hemorrhage (SAH). Methods from January 2015 to April 2016, 106 patients with a SAH received endovascular interventional therapy in the Department of Neurosurgery, Nanjing General Hospital of Nanjing military region, Nanjing military region. According to the occurrence or not, the patients were divided into DCI group (n = 34) and no DCI group (n = 72). General data of patients were collected, including sex, age, Hunt-Hess grade, modified Fisher classification, WFS classification, acute cerebral edema, early (1 to 3 days) hypoalbuminemia, hypohemoglobinemia and so on. The risk factors of DCI were analyzed by univariate and multivariate Logistic regression analysis. Results the incidence of DCI in 32.1%(34/106).DCI group was higher than that in 32.1%(34/106).DCI group, Hunt-Hess grade 鈮，

本文編號：1810532