血清LDL-C水平对老年男性高血压性脑出血血肿扩大的预测作用.pdfVIP

血清LDL-C水平对老年男性高血压性脑出血血肿扩大的预测

作用

周红霞;刘首峰;李玉旺;王欣;徐小林

【摘要】ObjectiveToinvestigatewhetherserumleveloflow-density

lipoproteincholesterolcanpredicttheexpan⁃sionofhemorrhagegrowth

inelderlymalepatientswithacutehypertensiveintracerebralhemorrhage.

MethodsPatients(n=108)whovisitedourhospitalwithfromJune2012

untilMay2014spontaneoushypertensiveintracerebralhemorrhage

with⁃in6hoursofonsetwhichisconfirmedbyinitialcomputed

tomography(CT)weresenttorepeatedCTwithin24hoursofon⁃set.All

selectedpatientsweredividedintotheLDL-C≥2.49mmol/Lgroupand

LDL-C2.49mmol/Lgroup.Clinicaldataofthese2groupswerecompared

andtherelationshipsofhematomagrowthanditsriskfactorswere

analyzed.ResultsBaselinebloodpressure,thelevelofbloodglucose,PT,

APTT,FIB,PLTandhemorrhagevolumedidnotdiffersignificantlybetween

theLDL-C≥2.49mmol/LgroupandLDL-C2.49mmol/Lgroup.Theratio

ofhemorrhagegrowthinLDL-C2.49mmol/Lgroupwassignificantly

higherthanthatinLDL-C≥2.49mmol/Lgroup(34.21%vs11.43%).Multiple

logisticregres⁃sionanalysisshowedthatLDL-C2.49mmol/Lwastheonly

riskfactorcontributetohemorrhagegrowth.ConclusionPa⁃tientswith

LDL-C2.49mmol/Linacuteintracerebralhemorrhageareofhighriskof

hemorrhagegrowthsoearlyattentionandappropriateprocedureare

neededtopreventorslowitsgrowth.%目的：探讨血清低密度脂蛋白胆固醇

（LDL-C）水平对老年男性高血压性脑出血急性期血肿扩大有无预测作用。方法收

集我院2012年6月—2014年5月发病6h以内的老年男性高血压性脑出血患者

108例，按发病时LDL-C水平分为LDL-C＜2.49mmol/L组和LDL-C≥2.49

mmol/L组，对2组患者入院时的收缩压（SBP）、舒张压（DBP）、血糖水平、

凝血酶原时间（PT）、部分活化凝血酶时间（APTT）、纤维蛋白原（FIB）、血

小板计数、血肿体积进行对比分析，并于发病24h复查头CT了解2组血肿扩大

情况并进行比较。应用Logistic回归模型，寻找对脑出血血肿扩大有预测价值的

危险因素。结果2组患者入院时SBP、DBP、血糖水平、PT、APTT、FIB、PLT、

血肿体积比较差异无统计学意义；LDL-C＜2.49mmol/L组的血肿扩大发生率高

于LDL-C≥2.49mmol/L组（34.21%vs11.43%，P＜0.05）。Logistic多元回归

分析显示，LDL-C＜2.4