基底节出血预后的判别分析研究

目的 探讨影响基底节出血预后的危险因素，建立基底节出血后30d内死亡或生存的判别模型。方法 回顾性分析我院近6年来病房收治的340例基底节出血病例，对影响基底节出血预后的危险因素进行单因素分析和多元判别分析。结果 340例基底节出血病人，30d死亡率为26．2％。单因素检验表明，意识障碍、出血量、脑出血破入脑室、出血半球、伴发缺血性心脏病、消化道出血等6个因素为影响基底节脑出血30d预后的危险因素（P＜0．05）。多元逐步判别分析发现仅有意识障碍、出血量、伴发消化道出血等3个因素可作为判别因子，所建判别方程内回代检验，判别符合率为87．6％。结论 意识水平、出血量和是否伴发消化道出血3个因素是影响基底节出血30d预后的最重要的危险因素，由此 建立的基底节出血30d生存和死亡的判别模型对临床具有一定的指导意义。

Multivariate discriminant analysis for assessing prognosis after intracerebral hemorrhage in the basal ganglia

Objective To determine the most important risk factors for prognosis in patients with intracerebral hemorrhage in the basal ganglia,and to develop a predictive model to evaluate 30-day outcome.Methods The medical records and CT scans of 340 patients with intracerebral hemorrhage in the basal ganglia were retrospectively reviewed. Independent risk factors of 30-day outcome were determined using univariate and multivariate statistical analyses.Results The 30-day mortality for the 340 cases of spontaneous supratentorial hemorrhage was 26.2%.Univariate analysis found initial level of consciousness,intraventricular spread of the hemorrhage,hemorrhage size,hemorrhage side,concomitant gastro-intestinal bleeding and ischemic heart disease to be significantly correlated with 30-day outcome( P <0.05).But multivariate discriminant analysis showed that initial level of consciousness,hemorrhage size and concomitant gastro-intestinal bleeding were significant independent predictors of 30-day outcome.Using these three categories variables,the resulting model can predicted 30-day death or survival with an overall exactness of 87.6%.Conclusion Initial level of consciousness,in combination with hemorrhage size and concomitant gastro-intestinal bleeding,was a powerful and ease-to-use predictor of 30-day outcome in patients with intracerebral hemorrhage in the basal ganglia. [