用凝血功能综合评分法分析高血压脑出血急性期血肿扩大的相关因素

目的旨在用凝血功能综合评分法(CFCS)分析高血压脑出血急性期血肿扩大的相关因素。方法收集2010年3月至2012年3月收治的高血压脑出血患者152例,其中男90例、女62例;年龄平均(54.7±11.3)岁。应用头颅CT观察患者急性期血肿扩大的情况。参照国际血栓和止血协会制定的凝血功能检测指标设计CFCS进行评分;对包括CFCS在内的多个血肿扩大危险因素进行单因素χ2检验及多因素Logistic回归分析。结果共入组152例患者,血肿体积平均(26.2±12.1)mL;入院时GCS评分平均(9.8±3.7)分。入选病例在急性期出现血肿扩大57例(37.5%)。χ2检验发现起病时血肿部位、入院时血压情况、CFCS评分等是血肿扩大的候选危险因素(P0.05)。将上述因素引入Logistic回归方程,逐步前进法分析得出入院时收缩压、CFCS评分、早期使用甘露醇是高血压脑出血急性期血肿扩大的独立危险因素。结论CFCS评分与高血压脑出血急性期血肿扩大以及预后密切相关,可以作为临床判断血肿扩大因素的参考指标,有利于早期发现血肿扩大并及时进行干预。

Analysis of the Related Factors of Hematoma Enlargement in Hypertensive Intracerebral Hemorrhage Patients Using Coagulation Functional Composite Score

Aim To investigate whether a high Coagulation Functional Composite Score （CFCS） is predictive for the hematoma enlargement of hypertensive intracerebral hemorrhage in acute phase using CFCS system.Methods According to the criteria,the patients with hypertensive intracerebral hemorrhage treated from March 2010 to March 2012 were collected.Their CFCS were measured in all the cases and head CT were used to detect the hematoma enlargement in acute phase.All the potential risk factors were analyzed by univariate x2 test and multivariate Logistic regression analysis.Results A total of 152 cases of patients were enrolled,including 106 cases and 71 female cases.Mean age was （54.7 ± 11.3） years old.The average hematoma volume was （26.2 ± 12.1） mL,average GCS score was 9.8 ± 3.7.In acute phase,the hematoma enlargement happened in 57 cases （37.5%）.x2 test showed that the position of hematoma,blood pressure on admission and CFCS,etc.were candidate risk factors for hematoma enlargement （P〈0.05）.Logistic regression analysis with gradually forward methods suggested that systolic blood pressure on admission,CFCS and early use ofmannitol were independent risk factors responsible for the hematoma enlargement in hypertensive intracerebral hemorrhage.Conclusion CFCS is closely related with the hematoma enlargement in hypertensive intracerebral hemorrhage.So a high CFCS is predictive for the hematoma enlargement and conducive to the early and timely intervention for hypertensive intracerebral hemorrhage.