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目的探讨脑出血患者血浆中脂联素浓度预测脑损害严重程度及早期病死率的意义。方法选择86例脑出血患者及30例对照组。用酶联免疫法分别检测其入院后第1、2、3、5及7天的血浆脂联素浓度,分析血浆脂联素水平与脑出血患者脑损害程度之间的关系。结果脑出血患者血浆脂联素浓度6h内明显升高,24h达高峰,持续2d后逐渐下降;其浓度7d内都明显高于对照组。多元相关分析显示,血浆脂联素水平可独立预测1周内脑出血患者病死率(OR=1.199,95%IC=1.035-1.389,P<0.05),并与患者入院时格拉斯哥昏迷(GCS)评分及血浆C反应蛋白水平密切相关(P<0.01)。血浆脂联素>16.4μg/ml预测患者1周病死率的敏感性为65.6%,特异性为90.7%。血浆脂联素浓度的预测价值低于GCS评分(P<0.01)及血肿量的体积(P<0.05)。结论脂联素可作为一种对脑出血早期病死率的独立预测因素。
Objective To investigate the significance of predicting the severity of brain damage and early mortality in patients with intracerebral hemorrhage. Methods 86 cases of cerebral hemorrhage and 30 cases of control group were selected. The concentrations of plasma adiponectin on the 1st, 2nd, 3rd, 5th and 7th days after admission were detected by enzyme-linked immunosorbent assay (ELISA), and the relationship between plasma adiponectin levels and brain damage in patients with cerebral hemorrhage was analyzed. Results The concentration of plasma adiponectin in patients with cerebral hemorrhage increased significantly within 6 hours and peaked at 24 hours, then decreased gradually after 2 days. The concentrations of plasma adiponectin in patients with cerebral hemorrhage were significantly higher than those in control group within 7 days. Multivariate correlation analysis showed that plasma adiponectin level could independently predict the mortality of patients with intracerebral hemorrhage in one week (OR = 1.199, 95% IC = 1.035-1.389, P <0.05), and was positively correlated with the GCS score And plasma C-reactive protein level (P <0.01). Plasma adiponectin> 16.4μg / ml predicted one-week mortality in patients with a sensitivity of 65.6%, a specificity of 90.7%. The predictive value of plasma adiponectin concentration was lower than that of GCS score (P <0.01) and hematoma volume (P <0.05). Conclusion Adiponectin may be used as an independent predictor of early mortality in patients with intracerebral hemorrhage.