摘要
目的探究重症颅脑损伤患者乳酸、红细胞参数[血红蛋白、红细胞比容]和白蛋白水平与预后的相关性。方法选取94例重症颅脑损伤患者,因失访脱落4例,实际纳入90例,患者入院24 h、48 h、72 h采集血液检测乳酸、血红蛋白、红细胞比容、白蛋白水平,以随访90 d格拉斯哥预后评分(GOS)分为预后良好组(4~5分)38例、预后不良组(1~3分)52例,利用倾向性评分匹配法消除混杂因素,获得一般资料平衡的两组患者(各38例),比较患者检测指标水平差异,分析检测指标间的关系及与预后的关系。结果预后不良组患者乳酸水平高于预后良好组,血红蛋白、红细胞比容、白蛋白水平低于预后良好组(P<0.05);重症颅脑损伤患者乳酸水平与患者血红蛋白、红细胞比容、白蛋白水平呈负相关(r=-0.271,-0.262,-0.468,P<0.05),血红蛋白与红细胞比容、白蛋白呈正相关(r=0.256,0.306,P<0.05),红细胞比容与白蛋白呈正相关(r=0.272,P<0.05);预后与乳酸水平负相关(r=-0.764,P<0.05),与血红蛋白、血红细胞比容、白蛋白水平正相关(r=-0.453,0.448,0.592,P<0.05)。结论重症颅脑损伤患者乳酸、血红蛋白、红细胞比容和白蛋白水平与预后有关,高乳酸、低血红蛋白、低红细胞比容或低白蛋白水平患者预后均较差,维持乳酸、血红蛋白、红细胞比容、白蛋白水平有助于改善预后。
Objective To explore the correlation between the levels of lactic acid,erythrocyte parameters(hemoglobin[Hb],hematocrit[HCT]),albumin(ALB),and prognosis in patients with severe craniocerebral injuries.Methods A total of 94 patients with severe craniocerebral injury were selected,and 90 cases were included due to loss of follow-up of 4 cases.At 24 h,48 h,72 h after hospitalization,blood collection was conducted for detection of the levels of lactic acid,Hb,HCT,and ALB.According to Glasgow Outcome Scale(GOS)score obtained at 90 d of follow-up,the patients were divided into a good prognosis group(GOS score:4-5 points,n=38)and a poor prognosis group(GOS score:1-3 points,n=52).The propensity-score matching(PSM)method was used to eliminate confounding factors and two groups that were balanced in general data(38 cases each)were obtained.The levels of detection indices were compared between the two groups.The relationship between the detection indices and their correlation with prognosis were analyzed.Results The poor prognosis group had a higher level of lactic acid than the good prognosis group and lower levels of Hb,HCT,and ALB,the difference was statistically significant(P<0.05).The level of lactic acid in patients with severe craniocerebral injury was negatively correlated with the levels of Hb,HCT,and ALB(r=-0.271,-0.262,-0.468,P<0.05);Hb level was positively correlated with the levels of HCT and ALB(r=0.256,0.306,P<0.05);HCT level was positively correlated with ALB level(r=0.272,P<0.05).The prognosis was negatively correlated with the level of lactic acid(r=-0.764,P<0.05),and was positively correlated with the levels of Hb,HCT,and ALB(r=-0.453,0.448,0.592,P<0.05).Conclusion The levels of lactic acid,Hb,HCT,and ALB in patients with severe craniocerebral injury are correlated to the prognosis.Patients with a high level of lactic acid,or low levels of Hb,HCT,or ALB have a poor prognosis.Maintaining the levels of lactic acid,Hb,HCT,and ALB is conducive to improving the prognosis of patients.
作者
邓义春
任民
彭伟
Deng Yichun;Ren Min;Peng Wei(Department of Neurosurgery,Pidu District People's Hospital,Chengdu,Chengdu,Sichuan,611730,China)
出处
《西南国防医药》
CAS
2020年第10期904-907,共4页
Medical Journal of National Defending Forces in Southwest China
基金
四川省医学科研青年创新课题(Q17052)。
关键词
重症颅脑损伤
乳酸
血红蛋白
红细胞比容
白蛋白
预后
相关性
severe craniocerebral injury
lactic acid
hemoglobin
hematocrit
albumin
prognosis
correlation
