铁蛋白在高血压脑出血后血肿周围脑水肿中作用及机制.docVIP

铁蛋白在高血压脑出血后血肿周围脑水肿中作用及机制 　　[摘要] 目的 探讨血清铁蛋白与高血压脑出血后血肿周围脑水肿的关系，并分析其在血肿周围脑水肿发生中发挥的作用及机制。 方法 采集2014年1月～2015年6月于北京丰台右安门医院神经外科住院治疗的38例高血压脑出血患者的临床资料和实验室数据，所有患者均在入院时及入院72 h后行血清铁蛋白及头颅CT检查，计算入院时及入院72 h后血肿体积、脑水肿总体积及经校正后的相对水肿体积。采用单因素方差分析与脑出血后血肿周围脑水肿相关的因素，采用Spearman相关系数分析血清铁蛋白与相对血肿周围脑水肿体积的相关性。 结果 入院当天患者脑血肿体积为（13.25±5.54）cm3，入院72 h后脑血肿体积为（30.26±11.28）cm3，差异无统计学意义（P 0.05）；入院72 h后患者脑水肿总体积为（49.37±14.23）cm3，较入院时脑水肿总体积[（30.26±11.28）cm3]显著增大（P 0.05）；入院72 h后相对水肿体积与血清铁蛋白呈显著正相关（r = 0.67，P 0.01）。 结论 血清铁蛋白是反映高血压脑出血后血肿周围脑水肿增大程度的一个重要指标，其在血肿周围继发性脑水肿的发生中起到重要的作用。 　　[关键词] 高血压脑出血；血清铁蛋白；血肿周围脑水肿 　　[中图分类号] R743.34 [文献标识码] A [文章编号] 1673-7210（2016）01（b）-0046-04 　　[Abstract] Objective To explore the association between serum ferritin and perihematoma edema of patients with hypertensive intracerebral hemorrhage， and to analyze its effects and mechanism in brain edema around the hematoma. Methods The clinical data and laboratory data of 38 patients with hypertensive cerebral hemorrhage treated in Department of Neurosurgery of Beijing Fengtai Youanmen Hospital from January 2014 to June 2015 were collected. Serum ferritin and cranial CT were tested at hospitalized and 72 h after admission. Hematoma volume， total volume of cerebral edema and relative edema volume at hospitalized and 72 h after admission were calculated. The factors associated with perihematoma edema in patients with cerebral hemorrhage were analyzed by one-way analysis of variance. The relationship between relative brain edema hematoma volume and serum ferritin was analyzed by Spearman correlation coefficient. Results The intracerebral hematoma volume at admission was （13.25±5.54） cm3， and （30.26±11.28） cm3 at 72 h after admission， the difference was not statistically significant （P 0.05）. The total volume of cerebral edema was （49.37±14.23） cm3 at 72 h after admission， which was significantly bigger than that at admission [（30.26±11.28） cm3] （P 0.05）. At 72 h after admission， serum ferritin was positively correlated with the relat