急性非创伤性脑出血患者肌钙蛋白Ⅰ升高的影响因素及临床意义

胡正涛; 张勇; 王俊; 王德国; 宋骏; 徐阳

doi:10.13201/j.issn.1009-5918.2021.07.003

急性非创伤性脑出血患者肌钙蛋白Ⅰ升高的影响因素及临床意义

- 1. 皖南医学院第一附属医院(弋矶山医院)老年医学科(安徽芜湖, 241001);
- 2. 皖南医学院第一附属医院(弋矶山医院)临床检验科;
- 3. 皖南医学院第一附属医院(弋矶山医院)神经内科
基金项目:
国家自然科学基金项目(No:81670301)

弋矶山医院高峰培育计划(No:KGF2019J10)

详细信息

通讯作者: 王德国,E-mail:wangdeguo@medmail.com.cn

中图分类号: R743.34,R542.2

收稿日期: 2021-03-24

Clinical significance of high cardiac troponin in patients with non-traumatic acute intracerebral hemorrhage

- 1. Department of Gerontology, First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui, 241001,, China;
- 2. Department of Clinical Laboratory, First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College;
- 3. Department of Neurology, First Affiliated Hospital of Wannan Medical College, Yijishan Hospital of Wannan Medical College

More Information

Corresponding author: WANG Deguo, E-mail: wangdeguo@medmail.com.cn

Received Date: 24 March 2021

摘要

摘要: 目的:部分急性脑出血(ICH)患者心肌损伤标志物肌钙蛋白I(cTnI)升高,本研究拟探讨急性非创伤性ICH患者cTnI升高的影响因素及其临床意义。方法:将338例确诊的急性非创伤性ICH住院患者根据cTnI是否≥0.04 ng/mL分成2组(cTnI升高组和正常组),比较2组间基本临床信息和脑出血部位及出血量,Logistic回归分析探讨cTnI升高的影响因素,以及cTnI升高是否影响患者短期预后,ROC曲线评价cTnI升高判断预后的价值。结果:共计95例cTnI升高(28.1%),相关性分析显示cTnI升高与合并肾功能不全、合并蛛网膜下腔出血、累及到岛叶相关区正相关(r分别为0.206,0.199,0.260,P<0.01),其中年龄(OR=1.050,95%CI:1.012~1.089,P=0.009)、岛叶相关区(OR=5.916,95%CI:2.199~15.916,P<0.001)及肾功能不全(OR=14.244,95%CI:3.616~56.114,P<0.001)是cTnI升高的独立影响因素。cTnI升高是ICH患者预后不良的独立影响因素(OR=2.377,95%CI:1.066~5.299,P=0.034)。cTnI升高预测急性非创伤性ICH患者不良预后的敏感度为0.554,特异度为0.786(AUC=0.727,95%CI:0.666~0.789,P<0.001)。结论:急性脑出血患者年龄、合并肾功能不全和岛叶相关区出血是cTnI升高的独立影响因素,且cTnI升高是住院期预后不良的独立危险因素。
- 急性脑出血 /
- 肌钙蛋白 /
- 岛叶 /
- 肾功能不全
Abstract: Objective: Some patients with acute intracerebral hemorrhage(ICH) show an increase of cardiac troponin(cTnI), one marker of cardiac injury. This study is to explore the relevant factors and clinical significance of cTnI in patients with non-traumatic ICH.Methods: A total 338 cases of ICH inpatients were divided into two groups based on plasma cTnI level(≥0.04 ng/mL, high cTnI group and normal group). The basic clinical information, hemorrhage volume and location and short-term prognosis inpatients were evaluated between the two groups. Logistics regression analysis the risk factors of high cTnI and poor outcome of ICH inpatients. Receiver-operating-characteristic(ROC) analysis evaluated judgment value of high cTnI on poor outcome.Results: 95 of 338 patients(28.1%) have high plasma cTnI. Correlation analysis showed that the high cTnI was positively associated with chronic renal insufficiency, subarachnoid hemorrhage, and insula involved areas(r was 0.206, 0.199, 0.260, P<0.01). Age(OR=1.050, 95%CI: 1.012-1.089, P=0.009), insula involved areas(OR=7.061 95%CI 2.582-19.310, P<0.01) and chronic renal insufficiency(OR=13.490, 95%CI 3.507-51.897, P<0.01) were independent risk factors of high cTnI. After adjusting for other factors, high cTnI was remained as an independent risk factor of poor outcome in patients with ICH(OR=2.377, 95%CI: 1.066-5.299, P=0.034). High cTnI showed significantly predict poor outcome of ICH with a sensitivity of 0.554 and a specificity of 0.786(AUC=0.727, 95%CI: 0.666-0.789, P<0.001).Conclusion: Age, chronic renal insufficiency and insula involved areas were independent factors of high cTnI in patients with ICH. High cTnI in plasma is an independent risk factor for poor outcome of ICH.
- acute cerebral hemorrhage /
- cardiac troponin /
- insula lobe /
- chronic renal insufficiency

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