高血压脑出血早期血肿扩大的危险因素及入院时GCS评分联合血糖水平的临床预测价值

目的探究高血压脑出血早期血肿扩大的危险因素及入院时格拉斯哥昏迷量表(GCS)评分联合血糖水平的临床预测价值。方法回顾性收集2014年10月至2018年10月在我院就诊的高血压脑出血患者106例,根据入院后头颅CT检查结果显示是否出现血肿扩大将患者分为扩大组(29例)及未扩大组(77例),比较两组患者一般资料,分析高血压脑出血早期血肿扩大的危险因素。采用受试者工作曲线(ROC)分析入院时GCS评分联合血糖水平预测高血压脑出血早期血肿扩大的价值。结果两组患者性别、年龄、血肿部位、入院时舒张压及长期吸烟史比较无明显差异(P>0.05);入院时GCS评分、入院时收缩压、空腹血糖、血肿形态及长期饮酒史比较存在明显差异(P<0.05)。多因素Logistic回归分析结果显示低入院时GCS评分、高入院时收缩压、高空腹血糖、血肿不规则及存在长期饮酒史是影响高血压脑出血患者早期血肿扩大的独立危险因素(P<0.05)。入院时GCS评分、血糖水平预测高血压脑出血早期血肿扩大时ROC曲线下面积(AUC)分别为0785和0.819,明显低于两者联合预测时的AUC(0.886,P<0.05)。结论低入院时GCS评分、高入院时收缩压、高空腹血糖、血肿不规则及存在长期饮酒史是影响高血压脑出血患者早期血肿扩大的独立危险因素,入院时GCS评分联合血糖水平预测高血压脑出血早期血肿扩大具有较高的临床价值。

Risk factors for early hematoma enlargement in hypertensive cerebral hemorrhage and clinical predictive value of GCS score combined with blood glucose level at admission

Objective To investigate the risk factors for early hematoma enlargement in hypertensive cerebral hemorrhage(HCH)and the clinical predictive value of(Glasgow Coma Scale)GCS score combined with blood glucose level at admission.Methods A retrospective collection was performed on 106 HCH patients who were treated in the hospital from October 2014 to October 2018.According to presence or absence of hematoma enlargement showed by examination results of brain CT after admission,they were divided into enlargement group(29 cases)and non-enlargement group(77 cases).The general data of the two groups were compared to analyze the risk factors for hematoma enlargement in early stage of hypertensive intracerebral hemorrhage.The receiver operating characteristic(ROC)curve was performed to analyze predictive value of GCS score combined with blood glucose level at admission for early hematoma enlargement in HCH.Results There were no significant differences in gender,age,hematoma location,diastolic blood pressure at admission or long-term smoking history between the two groups(P>0.05).There were significant differences in GCS score,systolic blood pressure at admission,fasting blood glucose,hematoma morphology and long-term drinking history at admission(P<0.05).The results of multivariate Logistic regression analysis showed that low GCS score,high admission systolic blood pressure,high fasting blood glucose,hematoma irregularity and long-term drinking history at admission were independent risk factors influencing early hematoma enlargement in HCH patients(P<0.05).The areas under ROC curve(AUC)of GCS score and blood glucose level at admission for predicting early hematoma enlargement of HCH 0875 and 0.819,respectively,significantly lower than that of their combination prediction(0.886,P<0.05).Conclusion Low GCS score,high systolic blood pressure at admission,high fasting blood glucose,hematoma irregularity and long-term drinking history at admission are independent risk factors influencing early hematoma enlargement in HCH patients.GCS score combined with blood glucose level at admission is of relatively higher clinical value for predicting early hematoma enlargement in HCH.