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脑出血患者的血脂水平与院内死亡率

Serum lipid levels and in-hospital mortality in patients with intracerebral hemorrhage.

作者信息

Roquer J, Rodríguez Campello A, Gomis M, Ois A, Munteis E, Böhm P

机构信息

Department of Neurology, Hospital del Mar, Barcelona, Spain.

出版信息

Neurology. 2005 Oct 25;65(8):1198-202. doi: 10.1212/01.wnl.0000180968.26242.4a.

Abstract

OBJECTIVE

To test the hypothesis that low serum cholesterol and low serum triglyceride levels at admission are related to an increase of in-hospital mortality in patients with first-ever supratentorial spontaneous intracerebral hemorrhage (ICH).

METHODS

The authors obtained the serum cholesterol and triglyceride levels during the first 48 hours after first-ever ICH in 184 patients. They analyzed the impact of serum cholesterol and triglyceride concentrations on the in-hospital mortality after adjustment for possible confounding variables according to the results of the univariate analysis (age, hemorrhage volume, intraventricular extension, glycemia, serum albumin, and Glasgow Coma Scale score at admission) using the Cox proportional hazards model. They also analyzed the survival curves according to the cholesterol and triglyceride quartiles.

RESULTS

Low serum cholesterol (p = 0.002; hazard ratio [HR] 0.988 [95% CI 0.979 to 0.997] mg/dL) and low serum triglyceride (p = 0.011; HR 0.986 [95% CI 0.976 to 0.997] mg/dL) concentrations were independently associated with increased in-hospital mortality after ICH. Analyzed by quartiles, the HR of in-hospital mortality was 3.136 (95% CI 0.833 to 11.087) for patients in the lowest cholesterol quartile (< 166 mg/dL) and 3.484 (95% CI 1.088 to 11.155) for patients in the lowest triglyceride quartile (< 74 mg/dL).

CONCLUSIONS

Low serum cholesterol and triglyceride levels obtained during the first hours after intracerebral hemorrhage (ICH) are strong independent predictors of in-hospital mortality in patients with spontaneous supratentorial ICH.

摘要

目的

检验首次幕上自发性脑出血(ICH)患者入院时血清胆固醇和甘油三酯水平低与住院死亡率增加相关这一假设。

方法

作者获取了184例首次ICH后48小时内的血清胆固醇和甘油三酯水平。他们根据单因素分析结果(年龄、出血量、脑室内扩展、血糖、血清白蛋白和入院时格拉斯哥昏迷量表评分),使用Cox比例风险模型分析了血清胆固醇和甘油三酯浓度对调整可能混杂变量后的住院死亡率的影响。他们还根据胆固醇和甘油三酯四分位数分析了生存曲线。

结果

血清胆固醇低(p = 0.002;风险比[HR] 0.988 [95%可信区间0.979至0.997] mg/dL)和血清甘油三酯低(p = 0.011;HR 0.986 [95%可信区间0.976至0.997] mg/dL)浓度与ICH后住院死亡率增加独立相关。按四分位数分析,胆固醇最低四分位数组(< 166 mg/dL)患者的住院死亡率HR为3.136(95%可信区间0.833至11.087),甘油三酯最低四分位数组(< 74 mg/dL)患者的住院死亡率HR为3.484(95%可信区间1.088至11.155)。

结论

脑出血(ICH)后最初数小时内获得的低血清胆固醇和甘油三酯水平是自发性幕上ICH患者住院死亡率的强有力独立预测因素。

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