两种血清标志物水平与急诊脑出血患者血肿病情的关系研究

目的：探讨急性脑出血患者的血肿扩大与血清总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）水平的关系。方法将2011年1月至2013年6月于急诊科就诊且收入神经内科病房住院的脑出血患者80例，分为血肿扩大组和对照组，血肿扩大组患者40例，对照组为血肿未扩大者40例，入院后立刻测量血压、血糖，并按照美国国立卫生研究院脑卒中量表进行评分，立刻行CT检查，在发病24 h内行第2次CT检查，并测量和计算血肿体积；于发病6 h内进行抽血检测TC和LDL-C的值。结果血肿扩大组的年龄、血糖、舒张压和收缩压明显高于对照组， TC和LDL-C明显低于对照组（P＜0．05）。logistic逐步回归模型筛选出的变量为：血糖（OR＝1．842，95％ CI：1．163～2．917，P＝0．009）、舒张压（OR＝1．172，95％ CI：1．040～1．321，P＝0．009）、收缩压（OR＝1．109，95％ CI：1．013～1．214，P＝0．025）、TC（OR＝0．055，95％ CI：0．004～0．756，P＝0．030）、LDL-C（OR＝0．002，95％ CI：0．001～0．004，P＝0．000）。结论急诊脑出血患者的血肿扩大与TC和LDL-C具有明显的负相关性。

Correlation of hematoma enlargement with serum TC and LDL-C levels in acute cerebral hemorrhage patients

Objective To explore the relation of hematoma enlargement with serum total cholesteral （TC） and low denstity lipoprotein cholesteral（LDL-C） levels in acute cerebral hemorrhage patients .Methods From January 2011to June 2013 ,80 cerebral hemorrhage patients in our hospital were separated into two groups ：hematoma enlarge-ment group and control group ,and hematoma enlargement group involoved 40 patients ,the control group selected 40 cases hospitalized at the same time without enlargement of hematoma .Blood pressure ,blood glucose were immediate-ly measured after admission ,and in accordance with the United States National Institutes of Health Stroke Scale score ,the CT values in initial and 24h were examined in 2 times ,and the measurement and calculation of the volume of hematoma .Blood detection of TC and LDL-C were implemented in the pathogenesis of 6h .Results The age ,blood glucose ,diastolic and systolic blood pressure of hematoma enlargement group were significantly higher than the con-trol group ,TC and LDL-C were significantly lower than the control group （P〈0 .05） .Logistic stepwise regression model selected variables ：blood glucose（OR= 1 .842 ,95% CI：1 .163 -2 .917 ,P= 0 .009） ,diastolic blood pressure （OR=1 .172 ,95% CI：1 .040-1 .321 ,P=0 .009） ,systolic blood pressure（OR=1 .109 ,95% CI：1 .013 -1 .214 ,P=0 .025） ,TC（OR= 0 .055 ,95% CI：0 .004 -0 .756 ,P= 0 .030） ,LDL-C （OR= 0 .002 ,95% CI：0 .001 -0 .004 ,P=0 .000） .Conclusion Hematoma enlargement has obvious negative correlation with TC and LDL-C in patients with a-cute cerebral hemorrhage hematoma .