【摘要】：目的探討血清鐵蛋白與高血壓腦出血后血腫周圍腦水腫的關系,并分析其在血腫周圍腦水腫發(fā)生中發(fā)揮的作用及機制。方法采集2014年1月~2015年6月于北京豐臺右安門醫(yī)院神經外科住院治療的38例高血壓腦出血患者的臨床資料和實驗室數據,所有患者均在入院時及入院72 h后行血清鐵蛋白及頭顱CT檢查,計算入院時及入院72 h后血腫體積、腦水腫總體積及經校正后的相對水腫體積。采用單因素方差分析與腦出血后血腫周圍腦水腫相關的因素,采用Spearman相關系數分析血清鐵蛋白與相對血腫周圍腦水腫體積的相關性。結果入院當天患者腦血腫體積為(13.25±5.54)cm3,入院72 h后腦血腫體積為(30.26±11.28)cm3,差異無統(tǒng)計學意義(P0.05);入院72 h后患者腦水腫總體積為(49.37±14.23)cm3,較入院時腦水腫總體積[(30.26±11.28)cm3]顯著增大(P0.05);相對水腫體積增加1.13倍。單因素方差分析顯示,高血清鐵蛋白水平(β=13.592,P0.01)及糖尿病(β=13.592,P0.01)是血腫周圍水腫體積增大的獨立危險因素。入院當天,患者血清鐵蛋白水平和相對水腫大小之間無明顯相關性(r=0.11,P0.05);入院72 h后相對水腫體積與血清鐵蛋白呈顯著正相關(r=0.67,P0.01)。結論血清鐵蛋白是反映高血壓腦出血后血腫周圍腦水腫增大程度的一個重要指標,其在血腫周圍繼發(fā)性腦水腫的發(fā)生中起到重要的作用。
[Abstract]:Objective to investigate the relationship between serum ferritin and perihematomas cerebral edema after hypertensive intracerebral hemorrhage (hypertensive intracerebral hemorrhage), and to analyze the role and mechanism of ferritin in the occurrence of perihematomas cerebral edema. Methods the clinical data and laboratory data of 38 patients with hypertensive intracerebral hemorrhage treated in the Department of Neurosurgery, Fengtai Youanmen Hospital, Beijing from January 2014 to June 2015 were collected. All patients were examined by serum ferritin and skull CT at admission and 72 hours after admission. The volume of hematomas, the total volume of brain edema and the corrected relative edema volume were calculated at admission and 72 hours after admission. Single factor variance analysis was used to analyze the factors related to perihematomas cerebral edema after intracerebral hemorrhage, and Spearman correlation coefficient was used to analyze the correlation between serum ferritin and relative perihematomas volume. Results the volume of cerebral hematomas was (13.25 鹵5.54) cm3, on the day of admission, and there was no significant difference in the volume of cerebral hematomas (30.26 鹵11.28) cm3, after admission 72 hours after admission (P 0.05). After 72 hours of admission, the total volume of brain edema was (49.37 鹵14.23) cm3, which was significantly higher than that of (30.26 鹵11.28) cm3 at admission (P 0.05), and the relative volume of edema increased by 1.13 times. Single factor analysis of variance showed that high serum ferritin level (尾 = 13.592, P 0.01) and diabetes mellitus (尾 = 13.592, P 0.01) were independent risk factors for the increase of edema volume around hematomas. On the day of admission, there was no significant correlation between serum ferritin level and relative edema size (r 鈮，

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