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炎症与HuntHess Ⅳ~Ⅴ级动脉瘤性蛛网膜下腔出血患者预后的相关性

  

  1. 荆州市第一人民医院 神经外科,湖北 荆州 434000
  • 出版日期:2017-03-05 发布日期:2017-03-06
  • 通讯作者: 通信作者:陈世洁, Email:1070546194 @qq.com

Association study between inflammation and prognosis of patients with HuntHess ⅣⅤ grade aneurismal subarachnoid hemorrhage

  1. Department of Neurosurgery, the First People’s Hospital of Jingzhou, Jingzhou 434000, China
  • Online:2017-03-05 Published:2017-03-06
  • Contact: Corresponding author: Chen Shijie, Email:1070546194@qq.com

摘要: 目的探讨HuntHess Ⅳ~Ⅴ级动脉瘤性蛛网膜下腔出血患者预后的影响因素。方法HuntHess Ⅳ、Ⅴ级动脉瘤性蛛网膜下腔出血患者49例,分析不同预后患者临床特征以及血液、脑脊液炎症相关指标的差异,并运用Logistic回归分析进行预后影响因素筛选。结果动脉瘤治疗方式、手术时机、Fisher分级、术后并发症等临床特征可能与患者预后相关(P<0.05);不同预后患者住院第1、3、7天的白细胞计数比较差异有统计学意义(P<0.05);不同预后患者C反应蛋白(CRP)水平存在差异,但不随时间变化而变化;首次脑脊液总蛋白、IgG含量存在差异(P<0.05);Logistic回归分析结果显示7天血白细胞计数、脑脊液IgG、3天CRP水平、治疗方式、Fisher分级、术后并发症可能影响了患者的预后(P<0.05)。 结论除治疗方式、 Fisher分级、术后并发症等相关影响因素外,炎症反应可能与HuntHess Ⅳ~Ⅴ级动脉瘤性蛛网膜下腔出血患者的预后相关。

关键词: 蛛网膜下腔出血, 动脉瘤, 白细胞, C反应蛋白

Abstract: ObjectiveTo investigate the factors on the prognosis of patients with HuntHess ⅣⅤ grade aneurismal subarachnoid hemorrhage.MethodsClinic characteristics, inflammation markers in blood and cerebrospinal fluid were investigated in 49 patients with HuntHess ⅣⅤ grade aneurismal subarachnoid hemorrhage; logistic regression was used for screening the factors  influencing the prognosis. ResultsThe treatment schemes, surgery time, Fisher classifications and postoperative complications were possibly associated with clinical outcomes (P<0.05); patients with different clinical outcomes had significantly different leucocytes on 1 d, 3 d and 7 d after admission(P<0.05); patients with different clinical outcomes had significantly different levels of CRP, but not with time; patients with different clinical outcomes had significantly different total protein and IgG in the cerebrospinal fluid (P<0.05); logistic regression showed that the factors influencing the prognosis were leucocytes on the seventh day, IgG in the cerebrospinal fluid and CRP on the third day, treatment scheme, Fisher classification and postoperative complication (P<0.05).ConclusionInflammation was possibly associated with the prognosis of patients with HuntHess ⅣⅤ grade aneurismal subarachnoid hemorrhage, treatment scheme, Fisher classification, and postoperative complication.

Key words: subarachnoid , hemorrhage, aneurysm, leukocytes, Creactive protein