Suzuki S, Kelley R E, Dandapani B K, Reyes-Iglesias Y, Dietrich W D, Duncan R C
Department of Neurology, University of Miami School of Medicine, Fla, USA.
Stroke. 1995 Jun;26(6):1020-3. doi: 10.1161/01.str.26.6.1020.
We undertook this study to investigate the relationship between outcome, hematoma volume, and admission peripheral white blood cell count and body temperature in acute hypertensive intracerebral hemorrhage.
Eighty-two consecutive patients who presented with hypertensive intracerebral hemorrhage within 72 hours of onset were retrospectively assessed. The peripheral white blood cell count, polymorphonuclear leukocytes, and the body temperature on admission were measured. The outcome at 30 days after ictus was determined with a modified Glasgow Outcome Scale. Correlation analysis was performed between these measurements and hematoma volume, which was calculated by brain computed tomography. We also looked at the presence or absence of intraventricular extension.
The mean hematoma volume was significantly greater in those patients who died compared with those with a good, moderate, and severe outcome (79.6 cm3 versus 10.7, 18.3, and 19.9 cm3, respectively; P < .0005). The mean peripheral white blood cell count was higher in those who died than in the other three groups (12.580 +/- 0.521 versus 8.160 +/- 0.543, 8.565 +/- 0.543, and 7.427 +/- 0.786 x 10(9)/L, respectively; P < .0005). The mean body temperature of those who died tended to be higher than those in the good-outcome group (99.12 +/- 0.21 versus 98.18 +/- 0.21 degrees F, P < .05). A positive linear correlation was observed between hematoma volume and white blood cell count (r = .506, df = 77, P < .001), as well as the polymorphonuclear leukocyte count (r = .561, df = 76, P < .001). A trend was also observed for admission temperature (r = .265, df = 74, P < .05). The leukocyte response was enhanced by the presence of intraventricular extension.
There is a relationship between the size of the hematoma and the degree of leukocytosis in hypertensive intracerebral hemorrhage. This relationship appears to most likely represent a stress-induced reaction of the white blood cell count.
我们开展这项研究以调查急性高血压性脑出血的预后、血肿体积与入院时外周血白细胞计数及体温之间的关系。
对82例在发病72小时内出现高血压性脑出血的连续患者进行回顾性评估。测量入院时的外周血白细胞计数、多形核白细胞及体温。发病30天后的预后采用改良格拉斯哥预后量表确定。对这些测量值与通过脑部计算机断层扫描计算出的血肿体积进行相关性分析。我们还观察了是否存在脑室扩展。
与预后良好、中等及严重的患者相比，死亡患者的平均血肿体积显著更大（分别为79.6 cm³ 与10.7、18.3及19.9 cm³；P <.0005）。死亡患者的平均外周血白细胞计数高于其他三组（分别为12.580±0.521与8.160±0.543、8.565±0.543及7.427±0.786×10⁹/L；P <.0005）。死亡患者的平均体温往往高于预后良好组（99.12±0.21与98.18±0.21华氏度，P <.05）。观察到血肿体积与白细胞计数之间呈正线性相关（r =.506，自由度 = 77，P <.001），与多形核白细胞计数之间也呈正线性相关（r =.561，自由度 = 76，P <.001）。入院体温也呈现出一种趋势（r =.265，自由度 = 74，P <.05）。脑室扩展会增强白细胞反应。
高血压性脑出血中血肿大小与白细胞增多程度之间存在关联。这种关联似乎最有可能代表白细胞计数的应激诱导反应。
