急性和亚急性脊髓损伤患者低血压和低钠血症的危险因素分析。

Risk factor analysis for low blood pressure and hyponatremia in acutely and subacutely spinal cord injured patients.

机构信息

Department of Neurosurgery, Tsukazaki Hospital, Himeji, Japan.

出版信息

Spinal Cord. 2012 Apr;50(4):285-8. doi: 10.1038/sc.2011.142. Epub 2011 Nov 29.

DOI:10.1038/sc.2011.142

PMID:22124346

Abstract

STUDY DESIGN

Case control.

OBJECTIVE

To clarify the predictors of low blood pressure (BP) and hyponatremia after spinal cord injury (SCI) and to discuss their pathophysiology.

SETTING

A SCI center in Japan.

METHODS

Age, gender, initial ASIA impairment scale (AIS) score, BP, blood electrolytes (sodium, K and Cl) and biochemical markers were evaluated at 1 month after injury. Risk factors of low BP and hyponatremia were analyzed using uni- and multivariate logistic regression models.

RESULTS

This study comprised of 172 SCI patients. Initial AIS score (Odds ratio (OR): 1.24, 95% confidence intervals (CI) 1.13-1.49, P-value <0.01) and hyponatremia (OR: 3.71, 95%CI 1.27-6.96, P<0.01) were the most important risk factors of low BP. As a second step, risk factors of hyponatremia were initial AIS score (OR: 1.36, 95%CI 1.08-2.78, P<0.01) and age (OR: 1.55, 95%CI 1.17-2.93, P<0.01).

CONCLUSIONS

In acute and subacute period, the more severe SCI and lower AIS score patients have the more frequently low BP and/or hyponatremia do appear.

摘要

研究设计

病例对照研究。

目的

阐明脊髓损伤（SCI）后低血压（BP）和低钠血症的预测因素，并探讨其病理生理学机制。

地点

日本的一家 SCI 中心。

方法

在损伤后 1 个月评估年龄、性别、初始 ASIA 损伤量表（AIS）评分、BP、血液电解质（钠、钾和氯）和生化标志物。使用单变量和多变量逻辑回归模型分析低 BP 和低钠血症的危险因素。

结果

本研究共纳入 172 例 SCI 患者。初始 AIS 评分（优势比（OR）：1.24，95%置信区间（CI）1.13-1.49，P 值 <0.01）和低钠血症（OR：3.71，95%CI 1.27-6.96，P<0.01）是低 BP 的最重要危险因素。作为第二步，低钠血症的危险因素是初始 AIS 评分（OR：1.36，95%CI 1.08-2.78，P<0.01）和年龄（OR：1.55，95%CI 1.17-2.93，P<0.01）。