血清CCCK-18水平与重度自发性脑出血患者早期死亡率的相关性分析

目的探讨半胱天冬酶裂解细胞角蛋白-18(CCCK-18)水平与重度自发性脑出血(SIH)患者早期死亡率的相关性。方法选取我院2016年1月至2018年6月收治的200例重度SIH患者[格拉斯哥昏迷量表(GCS)评分<8分]作为研究对象,并进行前瞻性研究。分析患者的性别、年龄、SIH部位、脑积水、清除SIH、SIH体积、中线移位、体温、氧合指数(PaO2/FiO2)、GCS评分、血糖、CCCK-18水平、急性生理与慢性健康评估-Ⅱ(APACHE-Ⅱ)评分对重度SIH患者死亡率的影响。结果200例重症SIH患者中,30 d内生存158例(79.0%),死亡42例(21.0%)。死亡组的年龄、SIH体积、中线移位、GCS评分、血糖、CCCK-18水平、APACHE-Ⅱ评分均显著高于生存组,差异具有统计学意义(P<0.05)。多因素Cox回归分析显示,GCS评分是影响患者30 d死亡率的保护因素,血清CCCK-18水平是影响患者30 d死亡率的独立危险因素(P<0.05)。结论重度SIH患者高血清CCCK-18水平与30 d内死亡率之间存在着相关性。

Correlation analysis between serum CCCK-18 level and early mortality in patients with severe spontaneous intracerebral hemorrhage

Objective To explore the correlation between serum caspase-cleaved cytokeratin-18(CCCK-18)level and early mortality in patients with severe spontaneous intracerebral hemorrhage(SIH).Methods A total of 200 patients with severe SIH[glasgow coma scale(GCS)score<8]admitted in our hospital from January 2016 to June 2018 were selected as the study objects,and the patients were prospectively studied.The influences of sex,age,location of SIH,hydrocephalus,clearance of SIH,volume of SIH,midline shift,body temperature,oxygenation index(PaO2/FiO2),GCS score,blood glucose,CCCK-18 level,and acute physiology and chronic health evaluation-Ⅱ(APACHE-Ⅱ)score on mortality of patients with severe SIH were analysed.Results Among 200 patients with severe SIH,158 cases(79.0%)survived within 30 days and 42 cases(21.0%)died.The age,SIH volume,midline shift,GCS score,blood glucose,CCCK-18 level and APACHE-Ⅱscore of the death group were all higher than those of the survival group,the differences were statistically significant(P<0.05).Multivariate Cox regression analysis showed that GCS score was the protective factor of30 day mortality,and serum CCCK-18 level was the independent risk factor of 30 day mortality(P<0.05).Conclusion There is a correlation between serum CCCK-18 level and 30 day mortality in patients with severe SIH.