| 毛文毅,赵呈进,赵振国,赵 丰,徐志云,陶学磊.2型糖尿病合并脑出血患者微创术后颅内感染与血液流变学的关系探究[J].,2022,(24):4786-4789 |
| 2型糖尿病合并脑出血患者微创术后颅内感染与血液流变学的关系探究 |
| Relationship between Intracranial Infection and Hemorheology in Patients with Type 2 Diabetes Mellitus and Cerebral Hemorrhage after Minimally Invasive Surgery |
| 投稿时间：2022-05-28 修订日期：2022-06-23 |
| DOI：10.13241/j.cnki.pmb.2022.24.037 |
| 中文关键词: 2型糖尿病 脑出血 颅内感染 血液流变学 |
| 英文关键词: Type 2 diabetes mellitus Cerebral hemorrhage Intracranial infection Hemorheology |
| 基金项目:江苏省卫生健康委科研项目（Z2020096） |
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| 中文摘要: |
| 摘要 目的：探讨2型糖尿病（T2DM）合并脑出血患者微创术后颅内感染与血液流变学的关系。方法：选取2017年1月～2021年12月于医院行微创术后颅内感染的2型糖尿病合并脑出血患者50例作为感染组，根据入院时格拉斯哥昏迷(Glasgow Coma Score, GCS)评分将患者分为轻度组（GCS≥9分，n=31）和重度组（GCS<9分，n=19），另按病例对照研究法选取同期行微创术后颅内未感染的50例患者为对照组。分析不同组患者血液流变学指标[全血黏度高切（HS）、全血黏度低切（LS）、血浆黏度（PV）和红细胞聚集指数（EAI）]的变化，并采用ROC评估根据术后HS、LS、PV、EAI预测颅内感染预后的效能。结果：感染组患者引流管数、引流管留置时间及脑脊液漏均高于对照组（P<0.05）；感染组患者LS、HS、PV和EAI均高于对照组患者（P＜0.05）；重度组患者LS、HS、PV和EAI均高于轻度组患者（P＜0.05）；预后不良组患者LS、HS、PV和EAI均高于预后良好组（P<0.05）；ROC曲线结果显示：HS、LS、PV和EAI预测患者术后颅内感染预后的AUC分别为0.698、0.837、0.690、0.666，最佳临界值为10.22 mPa?s、5.20 mPa?s、5.05 mPa?s、14.10。结论：T2DM合并脑出血微创术后颅内感染患者凝血功能及血液流变学指标异常升高，且对病情程度及预后预测中有一定应用价值。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the relationship between intracranial infection and hemorheology in patients with type 2 diabetes mellitus (T2DM) and cerebral hemorrhage after minimally invasive surgery. Methods: In the patients with T2DM and cerebral hemorrhage, 50 patients with intracranial infection after minimally invasive surgery in the hospital were enrolled as infection group between January 2017 and December 2021. According to scores of Glasgow Coma Scale (GCS) at admission, they were divided into mild group (GCS ≥9 points, n=31) and severe group (GCS <9 points, n=19). According to case control study, 50 patients without intracranial infection during the same period were enrolled as control group. The changes of hemorheology indexes in different groups were analyzed. The predictive efficiency of postoperative hemorheology indexes for prognosis of intracranial infection was evaluated by ROC curves. Results: The number of drainage tubes, indwelling time of drainage tube and cerebrospinal fluid leakage in infection group were higher than those in control group (P<0.05). The whole blood low-cut and high-cut viscosity, plasma viscosity and erythrocyte aggregation index in infection group were higher than those in control group (P<0.05). The whole blood low-cut and high-cut viscosity, plasma viscosity and erythrocyte aggregation index in severe group were higher than those in mild group (P<0.05), which were higher in poor prognosis group than good prognosis group (P<0.05). The results of ROC curves analysis showed that AUC and best cut-off values of whole blood low-cut viscosity, whole blood high-cut viscosity, plasma viscosity and erythrocyte aggregation index for predicting the prognosis of postoperative intracranial infection were (0.698, 0.837, 0.690, 0.666) and (10.22 mPa ?s, 5.20 mPa?s, 5.05 mPa?s, 14.10), respectively. Conclusion: The coagulation function and hemorheology indexes abnormally increase in intracranial infection patients with T2DM and cerebral hemorrhage after minimally invasive surgery, which have certain predictive value for conditions and prognosis. |
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