Influence Factors And Predictive Value Of Early Hematoma Enlargement In Hypertensive Intracerebral Hemorrhage

Objective: Through the analysis of the vital signs,biochemical indexes and image manifestations of the patients with hypertensive cerebral hemorrhage in the acute period,the related factors of the early hematoma enlargement of hypertensive cerebral hemorrhage and the predictive value of the enlargement of hematoma are explored in order to play a more effective guiding role in the clinical treatment of cerebral hemorrhage.Methods: The clinical data of 170 patients with hypertensive intracerebral hemorrhage in No.1 Hospital of Jilin University from October 2015 to September 2016 was retrospectively analyzed.According to the head CT and reexamination of CT,the patients were divided into the enlargement group of hematoma and the stable group of hematoma,and the general clinical features and laboratory tests were made according to the two groups patients.Indicators and imaging data were used to analyze the predictive value of factors affecting early hematoma enlargement and independent factors affecting hematoma enlargement.Results: The systolic pressure of admission,diastolic pressure,APTT,white blood cells,blood glucose,hematoma,alanine aminotransferase and gamma glutamine transpeptidase were all higher in the group of hematoma enlargement than those in the stable group of hematoma,and the difference between the two groups was statistically significant(P<0.05);The GCS scores of the two groups were statistically significant(t=13.225,P<0.001);the incidence of two groups of patients to the first CT scan time difference by comparison was statistically significant(t=4.638,P<0.001);the difference of hematoma location between the two groups was statistically significant(?2=6.135,P=0.047);whether the two groups of hematoma break into the ventricle and the shape of hematoma are regular,the difference is statistically significant(?2=10.147,P=0.001;?2=29.227,P<0.001).There was no statistically significant difference in age,sex,smoking history,drinking history,diabetes history,hypertension history,FBG,admission platelets,admission blood potassium,admission blood sodium and admission blood calcium between patients with hematoma expansion group and hematoma stable group(P >0.05).Multivariate analysis of admission systolic blood pressure,admission systolic blood pressure is higher,the risk of hematoma enlargement is higher,OR=1.129,95%CI for 1.029~1.238;for the GCS scores on admission,the higher the score,the risk of hematoma enlargement is small,OR=0.324,95%CI for 0.157~0.667;on admission blood glucose and alanine aminotransferase and the higher the value,the higher the risk of hematoma enlargement,OR was greater than 1;the factors of hematoma location,with thalamus as reference,the risk of enlargement of basal ganglia and other parts of hematoma is lower than that of the thalamus,OR was less than 1.Evaluation of prediction effect on admission systolic blood pressure,prediction sensitivity was 67.27%,specificity was 100%;for the admission GCS score,prediction sensitivity was 93.91%,specificity was 81.82%;for the admission blood glucose,predictive sensitivity was 81.82%,specificity was 76.52%;for alanine aminotransferase,predictive sensitivity was 58.18%,specificity was 83.48%.Conclusions: The study found that the admission systolic blood pressure and diastolic blood pressure on admission,admission GCS score,APTT,white blood cells,blood glucose,hematoma,admission,breaking into the ventricle,shape of hematoma,the first CT scan time,CT check the hematoma volume,alanine aminotransferase and gamma glutamyl transpeptidase were the influencing factors of hematoma enlargement.Multivariate analysis showed that patients' admission systolic blood pressure,admission GCS score,admission blood glucose,hematoma location and alanine aminotransferase were independent factors affecting hematoma enlargement.The prediction effect evaluation and analysis showed that the systolic blood pressure at admission was the highest specificity for predicting hematoma enlargement.The GCS score of admission patients had the highest sensitivity to predict hematoma enlargement.The GCS score at admission was the highest in predicting hematoma enlargement.