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目的探讨凝血功能与早期高血压性脑出血患者脑损伤及预后的关系。方法选取2014年4月至2015年8月于沈阳市第十人民医院就诊的137例早期高血压性脑出血患者作为研究对象,按照神经功能缺损情况分为轻、中、重3组,另外选择50名健康体检者作为对照组。检测4组患者入院时的凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、D-二聚体(DD)水平;出院时,再根据改良后的Rankin量表(MRS)将患者分为预后良好组(77例)和预后不良组(60例),比较两组患者的PT、APTT、DD水平。结果轻型组、中型组以及重型组患者入院时PT、APTT、DD值均明显高于对照组,且随脑损伤程度加重,患者的PT、APTT、DD值均呈递增趋势,差异均有统计学意义(均P<0.05);预后良好组患者出院时PT、APTT均明显短于预后不良组,DD水平明显低于预后不良组,差异均有统计学意义(均P<0.05)。结论对于高血压性脑出血患者,其神经功能损伤程度与凝血功能密切相关,且能影响预后。
Objective To investigate the relationship between coagulation function and brain injury and prognosis in patients with hypertensive cerebral hemorrhage. Methods A total of 137 patients with early hypertensive intracerebral hemorrhage who visited the Tenth People’s Hospital of Shenyang from April 2014 to August 2015 were selected as study subjects and divided into three groups according to their neurological deficits: light, moderate and severe. 50 healthy people as a control group. Prothrombin time (PT), activated partial thromboplastin time (APTT), and D-dimer (DD) levels were measured at admission in the 4 groups of patients. At the time of discharge from the hospital, the modified rankin scale (MRS) The patients were divided into good prognosis group (77 cases) and poor prognosis group (60 cases). The levels of PT, APTT and DD in the two groups were compared. Results The PT, APTT and DD values of patients in the light, middle and heavy groups were significantly higher than those in the control group at admission, and the PT, APTT and DD values showed an increasing trend with the increase of the degree of brain injury. The differences were statistically significant (All P <0.05). The PT and APTT in patients with good prognosis were significantly shorter than those with poor prognosis at discharge, and the levels of DD were significantly lower in patients with poor prognosis (all P <0.05). Conclusion In patients with hypertensive intracerebral hemorrhage, the extent of neurological impairment is closely related to coagulation and prognosis.