老年脑出血昏迷患者继发多器官功能障碍综合征（ＭＯＤＳ）危险因素的多元ｌｏｇｉｓｔｉｃ分析

分析老年脑出血（Ｃｅｒｅｂｒａｌｈｅｍｏｒｒｈａｇｅ，ＣＨ）昏迷患者继发多器官功能障碍综合征（ＭＯＤＳ）危险因素，为ＣＨ的治疗提供依据。方法　选取我院２０１２年１月—至２０１４年１月期间收治的老年ＣＨ昏迷患者１２５例，按照是否继发ＭＯＤＳ进行分组，将４３继发ＭＯＤＳ患者作为观察组，８２例未继发ＭＯＤＳ患者作为对照组。选择格拉斯哥昏迷指数（ＧＣＳ）评分、血糖、ＣＨ体积等７个因素对老年ＣＨ昏迷患者继发ＭＯＤＳ的情况实施单因素分析，并进行Ｌｏｇｉｓｔｉｃ回归性分析。结果　观察组４３例患者死亡率４６５１％，显著高于对照组死亡率７３２％（Ｐ＜００５）。且２个器官受累１８例，死亡６例，３个及３个以上器官受累２５例，死亡１４例。观察组格拉斯哥昏迷指数（ＧＣＳ）评分显著低于对照组。血糖、ＣＨ体积、急性生理与慢性健康－Ⅱ（ＡＰＡＣＨＥ－Ⅱ）评分、ＩＬ－１及ＩＬ－１０水平均显著高于对照组。差异均有统计学意义（Ｐ＜００５）。Ｌｏｇｉｓｔｉｃ回归性分析显示ＧＣＳ评分、血糖、ＣＨ体积、ＡＰＡＣＨＥ－Ⅱ评分、ＩＬ－１、ＩＬ－１０共计６个危险因素（Ｐ＜００５）。结论　ＧＣＳ评分、血糖、ＣＨ体积、Ａ ＰＡＣＨＥ－Ⅱ评分、ＩＬ－１、ＩＬ－１０为老年ＣＨ昏迷患者继发ＭＯＤＳ的危险因素，临床治疗中需给于高度关注。

Multivariate logistic analysis of risk factors of elderly patients with cerebral hemorrhage and coma for secondary multiple organ dysfunction syndrome ( MODS)

To study multivariate logistic analysis of risk factors of elderly patients with cerebral hemorrhage and coma for secondary multiple organ dysfunction syndromes ( MODS). Methods Selected 125 elderly patients of cere- bral hemorrhage from January 2012 to January 2014. According to whether had the secondary MODS group, 43 cases of secondary MODS patients as observation group, 82 cases of secondary MODS patients, as control group. In secondary MODS in elderly patients with CH in a coma, the implementation of single factor analysis and Logistic regression analysis of risk factors were obtained. Results The observation group 43 patients with a mortality rate of 46. 51% , significantly higher than the control group , the mortality was 7. 32% ( P < 0. 05 ). And the 2 0rgans were involved in 18 cases. 6 ca- ses died, 25 cases with 3 0r more than 3 0rgans, 14 cases of death. The observation group of Glasgow coma scale ( GCS) score was significantly lower than the control group. Blood sugar, CH volume. acute physiology and chronic health - II (APACHE - II ) score. IL - I and IL - 10 levels were significantly higher than the control group. They were statistically significant differences ( all P < 0. 05 ). According to Logistic regression analysis , the secondary MODS as dependent variable, the other factors as independent variables, GCS score, blood sugar, CH volume selection, A- PACHE - II score. IL - 1, 11 - 10 a total of six risk factors(P < 0. 05). Conclusion GCS score, blood sugar, CH vol- ume. APACHE - lI score, IL - 1. 11 - 10 for elderly patients with CH coma secondarv MODS risk factors, clinical treatment process should be given high attention.