幕上自发性脑出血患者早期预后影响因素的评估

目的 评估影响幕上自发必 出血患者早期预后的临床、实验室和影像学因素。方法 采用ＥＬＩＳＡ法检测５４例自发性幕上出血患者发病第１、２、３、４、７、１４ｄ的血清神经元特异性类醇化酶（ＮＳＰ）水平，计算脑实质内血肿体积，记录脑室出血积分、中线移位、入院时及病程中Ｇｌａｓｇｏｗ昏迷评分（ＧＣＳ）、发病３０ｄ时Ｇｌａｓｇｏｗ预后评分（ＧＯＳ）。检测入院时血压、血糖和周围血白细胞（ＷＢＣ）数。结果 预后恶劣

Evaluation of predictors of short-term outcome in patients with spontaneous supratentorial intracerebral hemorrhage

Objective To investigate the relationship between outcome and some clinical,laboratory and neuroradiology parameters in patients with spontaneous supratentorial intracerebral hemorrhage. Method Serum neuron specific enolase (NSE) concentraions were examined on days 1,2,3,4,7,and 14 after ictus in 54 patients with spontaneous supratentorial intracerebral hemorrhage by ELISA. Serial glasgow coma scale (GCS) was estimated at and after admission. We also determined the volume of parechymal hemorrhage,secondary intraventricular hemorrhage score,midline shift,blood pressure,blood glucose,and paeripheral WBC counts when the patients were admitted. Clinical outcome was assessed at 30 days after onset with the Glasgow outcome scale(GOS). Result Worse clinical outcome was correlated well with higher peak level of NSE,higher level of blood pressure,blood glucose,peripheral WBC counts,larger hematoma size or intraventricular hemorrhage score,lower GCS on admission,and the presence of midline shift (P<0.05). Multivariate analysis revealed that GCS on admission and peak level of NSE were independent predictors.None of patients with NSE level above 25ng/ml survived. A sudden increased serum NSE concentration indicated an unfavorable outcome. Conclusion All evaluated parameters can predict the short term neurological outcome objectively and reliably.