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目的探讨D-二聚体水平对自发性脑出血早期血肿扩大的影响。方法脑出血患者155例,均于发病6h内完成首次头颅CT检查,72h内复查头颅CT。检测血浆D-二聚体浓度和其他相关血生化指标。分析血浆D-二聚体浓度与早期血肿扩大的关系。结果 155例中,发生早期血肿扩大34例(血肿扩大组),另121例为血肿未扩大组。与血肿未扩大组比较,血肿扩大组患者入院时出血量较多,血肿形态相对不规则的发生率和中线移位发生率高,D-二聚体水平高(P<0.05)。血肿扩大与初始出血量和D-二聚体增高相关(OR值分别为2.63和1.82,95%CI为2.41-2.87和1.54-2.13;P<0.05)。结论 D-二聚体水平升高是自发性脑出血早期血肿体积扩大的危险因素。
Objective To investigate the effect of D-dimer on the early expansion of hematoma in spontaneous intracerebral hemorrhage. Methods A total of 155 patients with intracerebral hemorrhage were enrolled in this study. The first skull CT examination was completed within 6 hours of onset and skull CT was reviewed within 72 hours. Plasma D-dimer concentrations and other relevant blood biochemical parameters were measured. Analysis of the relationship between plasma D-dimer concentration and early hematoma enlargement. Results Among the 155 cases, 34 cases of early hematoma enlargement occurred (hematoma enlargement group), and the other 121 cases of hematoma did not enlargement group. Compared with the non-expansion hematoma group, hematoma enlargement group had more blood loss on admission, the incidence of hematoma was relatively irregular and the incidence of midline shift was high, and the level of D-dimer was higher (P <0.05). Hematoma enlargement was associated with an increased initial hemorrhage and increased D-dimer (OR, 2.63 and 1.82, respectively, 95% CI, 2.41-2.87 and 1.54-2.13; P <0.05). Conclusion D-dimer level is an important risk factor for early hematoma enlargement in spontaneous intracerebral hemorrhage.