| 引用本文: | 徐丽珊,韦鸿,王淼,黄秀琳,梁志坚.脑出血合并肺栓塞患者不良功能结局的危险因素分析[J].中国临床新医学,,():-. |
| xu li shan,wei hong,wang miao,huang xiu lin.脑出血合并肺栓塞患者不良功能结局的危险因素分析[J].中国临床新医学,,():-. |
|
| 摘要: |
| 目的 探讨脑出血（intracerebral hemorrhage, ICH）合并肺栓塞（pulmonary embolism, PE）患者发生不良功能结局的独立危险因素，为早期识别高危人群及改善患者预后提供参考。方法 回顾性分析2013年1月至2024年12月广西医科大学第一附属医院收治的152例ICH合并PE患者的临床资料。根据出院时改良Rankin量表评分将患者分为良好功能结局组与不良功能结局组。采用单因素分析筛选潜在危险因素，将P<0.05的变量纳入多因素logistic回归模型分析独立危险因素。构建了受试者工作特征（Receiver operating characteristic, ROC）曲线以确定预测ICH合并PE不良功能结局的联合预测指标的最佳临界值。 结果 152例患者中，约三分之一（32.9%）出院时存在不良功能结局，住院期间病死率为9.2%。多因素logistic回归分析结果显示，脑室内出血（intraventricular hemorrhage, IVH）（P = 0.021; OR 1.08，95%CI 1.01–1.15）, D-二聚体动态变化值1（ΔD-dimer 1 = 确诊PE时水平-入院时水平）（P = 0.013; OR 2.13, 95% CI 1.22–5.12）及全身炎症反应指数（systemic inflammatory response index, SIRI）（P = 0.042; OR 1.22，95%CI 1.01–1.49）升高是ICH合并PE发生不良功能结局的独立危险因素。结论 IVH、ΔD-dimer 1和SIRI水平升高是ICH合并PE患者发生不良功能结局的独立危险因素。 |
| 关键词: 脑出血 肺栓塞 功能结局 脑室内出血 D-二聚体 全身炎症反应指数 危险因素 |
| DOI： |
| 分类号: |
| 基金项目:国家自然科学基金项目（面上项目，重点项目，重大项目） |
|
| Risk factors for poor functional outcomes in intracerebral hemorrhage patients with pulmonary embolism |
|
xu li shan, wei hong, wang miao, huang xiu lin
|
|
The First Affiliated Hospital of Guangxi Medical University
|
| Abstract: |
| Objective To identify independent risk factors for poor functional outcomes in intracerebral hemorrhage (ICH) patients with pulmonary embolism (PE), aiming to facilitate early risk stratification and improve prognostication. Methods We conducted a retrospective analysis of 152 patients with ICH complicated by PE admitted to the First Affiliated Hospital of Guangxi Medical University between January 2013 and December 2024. Patients were stratified into two groups based on their good or poor functional outcome, as determined by the modified Rankin Scale (mRS) score at discharge. Variables with P < 0.05 in univariate analysis were entered into multivariable logistic regression to identify independent risk factors. Receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cutoff value of combined predictors for poor functional outcomes following PE in ICH patients. Results Among the 152 patients enrolled, 32.9% experienced poor functional outcomes at discharge, with an in-hospital mortality rate of 9.2%. Intraventricular hemorrhage (IVH) (P = 0.021; OR 1.08, 95%CI 1.01–1.15), elevated ΔD-dimer1 (the change in D-dimer from admission to PE diagnosis) (P = 0.013; OR 2.13, 95% CI 1.22–5.12), and increased systemic inflammatory response index (SIRI) (P = 0.042; OR 1.22, 95%CI 1.01–1.49) emerged as independent predictors of adverse outcomes in ICH patients with PE. Conclusion IVH, elevated ΔD-dimer1, and increased SIRI are independent risk factors for poor functional outcomes in ICH patients with PE. |
| Key words: Intracerebral hemorrhage Pulmonary embolism Functional outcome Intraventricular hemorrhage D-dimer Systemic inflammatory response index Risk factors |
