| 梁翠丹,罗且宁,王巍潼,等.收缩压、血糖、中性粒细胞计数、淋巴细胞计数对高血压性脑出血预测价值[J].安徽医药,2023,27(2):271-276. |
| 收缩压、血糖、中性粒细胞计数、淋巴细胞计数对高血压性脑出血预测价值 |
| Value of systolic blood pressure,blood glucose,neutrophil count and lymphocyte count in pre. dicting hypertensive intracerebral hemorrhage |
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| DOI：10.3969/j.issn.1009-6469.2023.02.013 |
| 中文关键词: 颅内出血，高血压性 危险因素 预测 |
| 英文关键词: Intracranial hemorrhage,hypertensive Risk factors Prediction |
| 基金项目:海南省重大科技计划项目( ZDKJ2016008)；海南省普通高等学校研究生创新科研课题( Hys2020-380) |
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| 中文摘要: |
| 目的分析高血压性脑出血( HICH)的危险因素及预测指标，为 HICH的防治提供依据。方法收取 2013年 1月至 2020年 6月在海南医学院第二附属医院住院的高血压病人 587例，其中 226例 HICH病人作为观察组， 361例无 HICH的高血压病人为对照组。收集两组脑梗死史，血压、血脂指标及血清胱抑素( CysC)等临床、检验指标，观察组在发生 HICH前的指标也收集。分析两组间和自身发病前、后各指标的差异，用多因素 logistic回归分析和 ROC曲线绘制来分析其与 HICH相关性及预测作用。结果单因素分析结果显示观察组收缩压［SBP，171(150，194)mmHg比 141(129，157)mmHg］、舒张压［SDP，95(86， 105)mmHg比 80(73，90)mmHg］、葡萄糖［GLU，7.44(5.94，9.73)mmol/L比 5.42(4.84，6.65)mmol/L］、中性粒细胞计数［NEUT， 8.64(5.87，12.02)×109mmol/L比 4.07(3.09，5.49)×109mmol/L］、白细胞计数( WBC)、高密度脂蛋白胆固醇( HDL-C)、载脂蛋白 A1(ApoA1)高于对照组( P<0.05)。低密度脂蛋白胆固醇( LDL-C)、脂蛋白 a(Lpa)在两组间差异无统计学意义( P>0.05)。多因素 logistic回归分析结显示有脑梗死史，高血压病程、 SBP、总胆固醇( TC)、 GLU、NEUT升高，淋巴细胞计数( LYM)降低，可能增加 HICH发生的风险( P<0.05)。且 NEUT、SBP、GLU、LYM的 AUC分别为 0.82、0.80、0.74、0.71(P<0.05)预测 HICH的临界值分别为 5.64×109 mmol/L、161 mmHg、6.35 mmol/L、1.23×109 mmol/L。结论有脑梗死史、高血压病程、 SBP、G，LU、TC、NEUT，LYM与 |
| 英文摘要: |
| Objective To explore the risk factors and predictors of hypertensive intracerebral hemorrhage (HICH), so as to providereference for the prevention and treatment of HICH.Methods A total of 587 patients with hypertension who were hospitalized in theSecond Affiliated Hospital of Hainan Medical University from January 2013 to June 2020 were selected, among which 226 patients withHICH were enrolled as the observation group, and 361 patients with hypertension without HICH were designated as the control group.Their blood pressure, blood lipid, serum cystatin (CysC) were collected from medical records. The indicators of HICH patients beforethe occurrence of HICH were also collected. The differences between the two groups and before and after the onset of the HICH wereanalyzed by t test, Chi-square test and willcox test. Multivariate logistic regression analysis and ROC curve were used to analyze its cor-relation with HICH and its predictive effect.Results Univariate analysis showed that the systolic blood pressure [SBP,171(150,194)mmHg min vs.141(129,157)mmHg],diastolic blood pressure[SDP,95(86,105) mmHg vs. 80(73,90) mmHg],glucose [GLU, 7.44 (5.94, 9.73) mmol/L vs. 5.42 (4.84,6.65) mmol/L],neutrophil count [NEUT,8.64(5.87,12.02)×109mmol/L vs. 4.07(3.09,5.49)×109 mmol/L], white blood cell count (WBC), apolipoprotein A1 (ApoA1),and high-density lipoprotein cholesterol (HDL-C) in the HICH group were higher than those in the control group (P<0.05).There was no difference in low-density lipoprotein cholesterol (LDL-C) and lipoprotein a (Lpa) between the two groups (P>0.05). Multivariate 1ogistic regression analysis indicated that history of cerebral infarction, the course of hy- pertension, SBP, GLU, total cholesterol (TC), and NEUT increased, while lymphocyte count (LYM) decreased, which might increase therisk of HICH (P<0.05). The results of ROC curves of NEUT, SBP, GLU and LYM for prediction of HICH showed that AUC were 0.822,0.799, 0.742 and 0.710, respectively. According to the principle of Youden index, the cut-off value of NEUT, SBP, GLU and LYM to predict the occurrence risk of HICH were 5.64×109mmol/L,161 mmHg, 6.35 mmol/L and 1.23×109mmol/L.Conclusion History of ce-rebral infarction, course of hypertension, SBP, GLU, TC,NEUT and LYM are associated with the risk of HICH. NEUT, SBP, GLU andLYM may predict the occurrence of HICH. |
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