血浆和肽素浓度与脑出血早期血肿扩大的相关分析

目的 揭示血浆和肽素浓度对脑出血早期血肿扩大的预测价值.方法选取106脑出血患者和106例健康体检者,采用ELISA法检测血浆和肽素浓度,记录血肿扩大病例,统计分析血浆和肽素浓度与血肿扩大的相关性.结果经t检验,脑出血患者血浆和肽素浓度（470.24±172.05）pg/mL较健康体检者（62.76±24.77）pg/ml显著升高（P〈0.01）.经Spearman相关分析,脑出血患者血浆和肽素浓度与血肿量（r=0.58,P〈0.01）和格拉斯哥昏迷评分（r=-0.57,P〈0.01）显著相关性.本组脑出血病例发生血肿扩大 32例（30.19%）.二分类Logistic回归分析显示,入院时血浆和肽素浓度是血肿扩大的独立危险因素（OR=1.22,95%CI=1.10~2.91,P〈0.01）.ROC曲线分析显示,血浆和肽素浓度显著预测血肿扩大（曲线下面积=0.86,95%CI=0.78~0.92,P〈0.01）,且血浆和肽素浓度大于414.03 pg/mL,对预测血肿扩大有87.50%的灵敏度和67.57%的特异度.结论血浆和肽素浓度与脑出血早期血肿扩大密切相关.

Analysis of correlation between plasma copeptin concentration and early hematoma growth of intracerebral hemorrhage

Objective To discover predictive value of plasma copeptin concentration for early hematoma growth of intracerebral hemorrhage. Methods 106 patients with intraeerebral hemorrhage and 106 healthy controls were chosen, plasma copeptin concentration was determined using ELISA. Cases with hematoma growth were recorded, and correlation of plasma copeptin concentration with hematoma growth was analyzed statistically. Results Plasma copeptin concentration in patients with intracerebral hemorrhage （470.24＋172.05 pg/mL） was markedly higher （P〈0.01） than that in healthy controls （62.76_＋24.77 pg/ml）. Using Spearman correlation analysis, plasma copeptin concentration was statistically significantly associated with hematoma volume （r=0.58, P〈0.01） and Glasgow Coma Scale score （r=-0.57, P〈0.01） in patients with intracerebral hemorrhage. Among this group of cases with intracerehral hemorrhage, 32 cases （30.19%） had hematoma growth. Binary Logistic regression analysis showed plasma copeptin concentra- tion was an independent risk factor for hematoma growth （odds ratio=l.22, 95% confidence interval =1.10-2.91, P〈0.01）. Receiver operating characteristic analysis showed that plasma copeptin concentration markedly predicted hematoma growth （area under curve=0.86, 95% confidence interval= 0.78~0.92, P〈0.01）, and plasma copeptin concentration of more than 414.03 pg/mL predicted hematoma growth with sensitivity of 87.50% and specificity of 67.57%. Conclusions Plasma copeptin concentration was associated highly with early hematoma growth of intracerebral hemorrhage.