撤稿:不同血钙水平与不同人群脑出血关系的研究

The Research on the Relation between Different Serum Calcium Levels and Cerebral Hemorrhage in Different Populations

摘要: 撤稿声明：目的：探讨不同血钙水平与不同人群血压升高、脑出血发生及脑出血血肿体积的关系的研究。方法：回顾性分析老年性高血压患者130例，根据是否发生脑出血将上述患者分为无脑出血组及脑出血组两组，其中无脑出血组患者65例，发生脑出血患者65例，同时搜集同时间段尿毒症规律透析患者109例，同样的根据其有无发生脑出血分为无脑出血组及脑出血组两组，其中无脑出血组患者65例，脑出血组患者44例，搜集上述4组患者临床基线资料、实验室指标，采用格拉斯哥昏迷评分(Glasgow Coma Scale, GCS)进行神经功能缺损评估，根据头颅CT计算脑出血患者血肿体积，组间计数资料比较采用卡方检验，正态定量资料比较采用独立样本t检验，非正态定量资料比较采用秩和检验，相关性研究采用Spearman相关性分析。结果：在老年性高血压患者脑出血组具有更低的血清钙水平，更高的收缩压和舒张压，差异具有统计学意义(2.155 ± 0.160 mmol/L vs 2.267 ± 0.107 mmol/L, P < 0.001; 183.220 ± 24.725 vs 142.190 ± 19.792 mmHg, P < 0.001; 102.730 ± 17.022 vs 82.900 ± 15.262 mmHg, P < 0.001)，Spearman相关性分析中，脑出血组患者血清钙水平与脑内血肿体积呈负相关(r = −0.951, P = 0.000)，与GCS评分呈正相关(r = 0.543, P = 0.000)，差异具有统计学意义，在尿毒症维持性血液透析患者，脑出血组具有更高的血钙，更高的收缩压和舒张压，差异具有统计学意义(2.104 ± 0.212 vs 1.958 ± 0.275 mmol/L, P = 0.004; 184.810 ± 24.081 vs 145.910 ± 19.663 mmHg, P < 0.001; 103.930 ± 14.608 vs 81.660 ± 14.082 mmHg, P < 0.001)，Spearman相关性分析中脑出血患者中血清钙水平与脑内血肿体积呈正相关(r = 0.898, P = 0.000)，与GCS评分呈负相关(r = −0.428, P = 0.004)，差异具有统计学意义。结论：不同血清钙水平对不同人群的血压水平、脑出血发生率、血肿体积及GCS评分有不同的影响，临床上要根据不同的人群制定针对性的血清钙水平纠正策略。

Abstract: Objective: To investigate the effects of different serum calcium levels on the increase in blood pressure, the occurrence of cerebral hemorrhage and the volume of cerebral hemorrhage in different populations. Methods: A retrospective analysis of 130 elderly patients with hypertension was conducted. According to whether cerebral hemorrhage occurred, the above patients were divided into two groups: no cerebral hemorrhage group and cerebral hemorrhage group. Among them, there were 65 patients without cerebral hemorrhage and 65 patients with cerebral hemorrhage. At the same time, 109 regular dialysis patients with uremia at the same time period were collected. Similarly, according to whether they had cerebral hemorrhage, they were divided into two groups: non-cerebral hemorrhage group and cerebral hemorrhage group. Among them, there were 65 patients without cerebral hemorrhage group and 44 patients in cerebral hemorrhage group, collect the clinical baseline data and laboratory indicators of the above 4 groups of patients, use the Glasgow Coma Score (GCS) to evaluate neurological deficits, calculate the hematoma volume of patients with cerebral hemorrhage based on head CT, and compare the count data between groups using the chi-square test and normal quantification data comparison uses independent sample t test, non-normal quantitative data comparison uses rank sum test, and correlation study uses spearman correlation analysis. Results: In the cerebral hemorrhage group of elderly hypertensive patients, there were lower serum calcium levels, higher systolic and diastolic blood pressure, and the difference was statistically significant (2.155 ± 0.160 mmol/L vs 2.267 ± 0.107 mmol/L, P < 0.001; 183.220 ± 24.725 vs 142.190 ± 19.792 mmHg, P < 0.001; 102.730 ± 17.022 vs 82.900 ± 15.262 mmHg, P < 0.001). In the Spearman correlation analysis, the serum calcium level in the cerebral hemorrhage group was negatively correlated with the volume of intracerebral hematoma (r = −0.951, P = 0.000), positively correlated with GCS score (r = 0.543, P = 0.000), the difference is statistically significant, in patients with uremic maintenance hemodialysis, cerebral hemorrhage group has higher serum calcium, higher systolic and diastolic blood pressure, the difference was statistically significant (2.104 ± 0.212 vs 1.958 ± 0.275 mmol/L, P = 0.004; 184.810 ± 24.081 vs 145.910 ± 19.663 mmHg, P < 0.001; 103.930 ± 14.608 vs 81.660 ± 14.082 mmHg, p < 0.001). In the Spearman correlation analysis, the serum calcium level in patients with cerebral hemorrhage was positively correlated with intracerebral hematoma volume(r = 0.898, P = 0.000), and negatively correlated with GCS score (r = −0.428, P = 0.004), the difference is statistically significant. Conclusion: Different serum calcium levels have different effects on blood pressure levels, cerebral hemorrhage incidence, hematoma volume and GCS scores in different populations. Clinically, specific corrective strategies for serum calcium levels should be developed according to different populations.