1 新乡医学院第一附属医院神经内科，河南 卫辉 453100
目的：探讨血清铁蛋白(serum ferritins，SF)、皮质醇(cortisol，Cor)及同型半胱氨酸(homocysteine，Hcy)与高血压脑出血患者预后的关系。方法：选择2015年3月至2016年7月新乡医学院第一附属医院96例高血压脑出血患者为观察组，选取同期90例健康体检者为对照组。比较两组血清SF，Cor及Hcy水平，观察不同神经损伤程度及不同预后患者血清SF，Cor及Hcy水平差异，研究不同预后患者临床特征差异。结果：观察组血清SF，Cor及Hcy水平显著高于对照组，差异具有统计学意义(P<0.05)。脑出血患者随神经损伤程度的加重，血清SF，Cor及Hcy水平则显著升高(P<0.05)。预后良好组血清SF，Cor及Hcy水平显著低于预后不良组，差异具有统计学意义(P<0.05)。预后良好组中年龄<60岁、血肿量<30 mL及出血未破入脑室者所占比例明显高于预后不良组，差异具有统计学意义(P<0.05)。SF，Cor，Hcy，年龄，血肿量及破入脑室是影响高血压脑出血患者预后的独立危险因素(P<0.05)。结论：SF，Cor及Hcy参与高血压脑出血的发生和发展，其水平与患者神经损伤程度及预后密切相关。关键词： 脑出血；高血压；铁蛋白；皮质醇；同型半胱氨酸；预后
Relationship between serum ferritins, cortisol, homocysteine and prognosis of patients with hypertensive intracerebral hemorrhage
Foundation: This work was supported by the Foundation from Henan Provincial Department of Health, China (201303105).
Objective: To investigate the relationship between serum ferritins (SF), cortisol (Cor), homocysteine (Hcy) and prognosis of patients with hypertensive intracerebral hemorrhage. Methods: A total of 96 patients with hypertensive intracerebral hemorrhage treated in the First Affiliated Hospital of Xinxiang Medical University from March 2015 to July 2016 were enrolled as the observation group and 90 healthy peoples were enrolled as the control group. The levels of SF, Cor and Hcy were compared in two groups. The differentiation of SF, Cor and Hcy levels were observed in patient with different degree of nerve injury and different prognosis. The differences of clinical feature in patients with different prognosis were studied. Results: The levels of SF, Cor and Hcy in observation group were significantly higher than those in control group (P<0.05). The levels of SF, Cor and Hcy in patents with hypertensive intracerebral hemorrhage were significantly increased as nerve injury increased progressively (P<0.05). The levels of SF, Cor and Hcy in good prognosis group were significantly lower than those in poor prognosis group (P<0.05). The rate of age younger than 60, bleeding volume less than 30mL and hemorrhage not breaking into ventricle in good prognosis group were significantly higher than those in poor prognosis group (P<0.05). In patients with hypertensive intracerebral hemorrhage, SF, Cor, Hcy, ages, bleeding volume, hemorrhage not breaking into ventricle were independent prognostic risk factors (P<0.05). Conclusion: SF, Cor and Hcy may be involved in the occurrence and development of hypertensive intracerebral hemorrhage. The levels of those indexes are closely correlated with the injury of nerve degree and prognosis.Keywords： cerebral hemorrhage; hypertension; ferritins; cortisol; homocysteine; prognosis