幕上高血压脑出血预后影响因素多重线性回归分析.docVIP

幕上高血压脑出血预后影响因素多重线性回归分析 　 作者：蒋永祥，彭博，马颖，陈维福，程远 【摘要】 目的 探讨影响幕上高血压脑出血（SICH）患者预后的相关因素，以指导临床治疗和评估预后。方法 回顾性分析符合本研究纳入标准的幕上高血压脑出血324例完整病历。以一般资料、起病症状、入院查体、影像学资料、治疗方式、并发症等43项为自变量，以发病后1个月后功能独立性评定评分（functional independence measure，FIM）为因变量，建立多重线性回归模型，筛选出对预后有影响的因素，并比较各因素的影响大小。结果 经统计学处理发现血肿体积、入院时收缩期血压、GCS评分、脑室是否积血、血肿体积扩大、是否并发肺部感染和应激性溃疡等7项对预后有显著性的影响。结论 血肿体积、入院GCS评分和脑室是否积血对预后影响有重要意义，可作为SICH患者预后的关键性指标。 【关键词】 高血压脑出血；幕上出血；预后；多重线性回归分析 Multiple regression analysis on the prognosis supratentorial hypertensive intracerebral hemorrhage Abstract: Objective To discuss the influence clinical factors of supratentorial hypertensive intracerebral hemorrhage. Methods Totally 324 consecutive cases were studied, general information, onset symptoms, physical examination on admission, features on CT scan, treatment strategies and complications such as pulmonary infection and stress ulcer were used as independent valuations. Prognosis was judged with functional independence measure (FIM) after 1 month. The valuable influence factors were filtrated and formulated with multiple regression analysis models. Results The data were processed with statistic software, volume of haematoma, Glasgow Coma Score on admission, intraventricular hemorhage, pulmonary infection was found in the period of treatment, hematoma enlargement, stress ulcer, systolic blood pressure on admission, were found to affect the prognosis. Conclusion Volume of haematoma, Glasgow Coma Score on admission, intraventricular hemorhage affect the prognosis of supratentorial hypertensive intracerebral hemorrhage most significantly, and were considered as key indexes to prognosis of SICH. Keywords: hypertensive intracerebral hemorrhage; supratentorial hemorrhage; prognosis; multiple regression analysis 高血压脑出血是一危及人类生命和生存质量的严重疾病，尽管其发病率仅占所有脑卒中的10%～15%［12］，但其病死率却高达35%～52%，幸存者中80%留有不同程度的残疾［3］，给家庭和社会带来了巨大负担。有关高血压脑出血的预后评估和影响因素一直存在争议，其中重要原因之一在于既往针对该病预后影响因素的研究主要是通过单因素分析，缺乏循证医学和全面科学研究。本研究通过量化指标对幕上高血压脑出血（supratentorial hypertensive intracerebral hemo