Crit Care Med:动脉瘤性蛛网膜下腔出血患者镁与出血量的关系

2019-11-09 xing.T MedSci原创

由此可见,这些数据支持以下假设:镁可能通过止血机制影响动脉瘤蛛网膜下腔出血患者的出血严重程度。

近日,危重病医学领域权威杂志Critical Care Medicine上发表了一篇研究文章,研究人员旨在检验以下假设:动脉瘤性蛛网膜下腔出血患者的入院血清镁水平与出血程度有关。

该研究是在三级医院神经内科ICU患者中进行的单中心前瞻性观察性研究,参与者为动脉瘤性蛛网膜下腔出血患者,干预措施为临床指征的CT扫描和血清实验室检查。研究人员分析了人口统计学、临床、实验室和影像学数据。使用改良的Fisher量表在入院CT扫描中对初次出血的程度进行半定量分级(等级:0,无影像学出血;1,蛛网膜下腔出血[深度小于1毫米];2,蛛网膜下腔出血伴脑室内出血;3 ,蛛网膜下腔出血[≥1毫米];4,蛛网膜下腔出血伴脑室内出血)。研究人员使用序数(改良的Fisher量表)和二分法(厚vs薄蛛网膜下腔出血)单变量并调整logistic回归模型来评估血清镁与X线蛛网膜下腔出血严重程度之间的关联。

该研究共分析了354例患者的数据(平均年龄为55±14岁,男性占28.5%,中位入院格拉斯哥昏迷量表评分为14 [10-15])。蛛网膜下腔出血较重的患者平均镁含量较低(1.92 vs. 1.99mg/dL;p=0.022)。使用方差分析和Spearman等级相关性(分别为p=0.015和p=0.008)发现,在经过修正的Fisher量表类别中存在单一趋势。在调整的序数和二元回归模型中,较低的镁水平与较高的改良Fisher量表得分(每增加1mg/dL的比值比为0.33;95%CI为0.14-0.77;p=0.011)和蛛网膜下腔出血严重(每增加1mg/dL的比值比为0.29;95%CI为0.10–0.78;p=0.015)相关。

由此可见,这些数据支持以下假设:镁可能通过止血机制影响动脉瘤蛛网膜下腔出血患者的出血严重程度。 

原始出处:

Liotta, Eric M.et al.Magnesium and Hemorrhage Volume in Patients With Aneurysmal Subarachnoid Hemorrhage.critical care medicine.2019.https://journals.lww.com/ccmjournal/Abstract/onlinefirst/Magnesium_and_Hemorrhage_Volume_in_Patients_With.95803.aspx

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