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自发性脑出血患者高敏肌钙蛋白 I 水平、血肿量与格拉斯哥昏迷评分的预后关系。

Prognostic relationship between high sensitivity troponin I level, hematoma volume and glasgow coma score in patients diagnosed with spontaneous intracerebral hemorrhage.

机构信息

Department of Emergency Medicine, Health Science University, Adana City Research and Training Hospital, Adana, Turkey.

Department of Emergency Medicine, Ankara Bilkent City Hospital, Ankara, Turkey.

出版信息

Ir J Med Sci. 2024 Oct;193(5):2559-2565. doi: 10.1007/s11845-024-03737-y. Epub 2024 Jun 18.

Abstract

BACKGROUND

Intracranial hemorrhages is one of the major causes of mortality and morbidity worldwide, and there is still no effective biomarker to predict prognosis.

AIM

We aimed to determine the effectiveness of high sensitive troponin I (hs-cTn-I) levels to predict the prognosis of spontaneous intracerebral hemorrhage (sICH) by comparing Glasgow Coma Score (GCS) and hematoma volume with hs-cTn-I levels.

METHODS

This study was planned as a retrospective observational study. Patients with available data, over 18 years old and sICH were included in the study. Cerebral computed tomography images were evaluated by a senior radiologist. Hematoma volume was calculated using the ABC/2 formula.

RESULTS

The study comprised 206 individuals in total 78 (37.86%) women and 128 (62.13%) men. Forty-four (21.35%) of patients died. The sensitivity of GCS, hs-cTn-I, and hematoma volume values were 86.36%, 66.67%, and 59.46%, respectively, with corresponding specificities of 78.75%, 93.02%, and 87.58%. Patients with hs-cTn-I values over 26, GCS values of ≤ 9, and hematoma volume values above 44.16 were found to have higher risk of mortality (p = 0.011; p < 0.001; p < 0.001, respectively). The mortality rates were found to be increased 2.586 (IQR: 1.224-5.463) times in patients with hs-cTn-I values above 26, 0.045 times (IQR: 0.018-0.115) in patients with GCS values ≤ 9, and 7.526 times (IQR: 3.518-16.100) in patients with hematoma volume values above 44.16.

CONCLUSIONS

Our findings suggest that hs-cTn-I values exceeding 26 units may serve as effective biochemical markers for predicting the prognosis of patients with sICH.

摘要

背景

颅内出血是全球范围内导致死亡率和发病率的主要原因之一,但仍没有有效的生物标志物来预测预后。

目的

我们旨在通过比较格拉斯哥昏迷评分(GCS)和血肿体积与高敏肌钙蛋白 I(hs-cTn-I)水平,确定高敏肌钙蛋白 I(hs-cTn-I)水平预测自发性脑出血(sICH)预后的有效性。

方法

本研究计划为回顾性观察性研究。纳入研究的患者有可用数据,年龄超过 18 岁且患有 sICH。由一名资深放射科医生评估脑计算机断层扫描图像。使用 ABC/2 公式计算血肿量。

结果

研究共纳入 206 例患者,其中 78 例(37.86%)为女性,128 例(62.13%)为男性。44 例(21.35%)患者死亡。GCS、hs-cTn-I 和血肿量的灵敏度分别为 86.36%、66.67%和 59.46%,相应的特异度分别为 78.75%、93.02%和 87.58%。hs-cTn-I 值超过 26、GCS 值≤9 和血肿量值超过 44.16 的患者有更高的死亡风险(p=0.011;p<0.001;p<0.001,分别)。发现 hs-cTn-I 值超过 26 的患者死亡率增加了 2.586 倍(IQR:1.224-5.463),GCS 值≤9 的患者死亡率降低了 0.045 倍(IQR:0.018-0.115),血肿量值超过 44.16 的患者死亡率增加了 7.526 倍(IQR:3.518-16.100)。

结论

我们的研究结果表明,hs-cTn-I 值超过 26 单位可能是预测 sICH 患者预后的有效生化标志物。

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