Relationship between serum hypocalcemia and early enlargement and poor prognosis of ICH

Ref: Zhang YB,et alWorld Neurosurg2018 Oct;118:e500-e504doi: 10.1016/j.wneu.2018.06.223Epub 2018 Jul 6.)has reported that lower serum total calcium levels in patients with spontaneous cerebral hemorrhage (ICH) were associated with an increase in early hematomaTotal calcium (total calcium, tCa) consists of 3 parts: organic acid binding calcium, accounting for 13%, plasma protein binding calcium, accounting for 40% and free ion calcium (ion calcium, iCa), accounting for 47%Serum ion calcium has physiological activity and is a coagulation factor IV, which plays an important role in the process of coagulation protogens and coagulation progenitors to coagulation progenyLow ioncalcemia can lead to increased arterial vascular tension and increased blood pressureThe correlation between serum free ion calcium and early hematoma expansion of hypertension brain haemorrhage has not been clearly definedAnalysis of blood gas analysis indicators in ICH patients by Yi-Bin Zhang, neurosurgery at Dehua County Hospital in Fujian Province, China, found that ionized calcium (iCa) can cause early expansion of cerebral hematoma and affect the prognosis of function after 3 months, while serum total calcium (tCa) has no obvious effect on thisThe findings were published online in The June 2018 issue of World Businessthe study collected clinical data on 111 patients with hypertension and cerebral hemorrhage between January 2015 and December 2017 to obtain ionized calcium, serum total calcium, clotting function, initial CT hematoma at admission and hematoma in 6h during admission; Patients were divided into hematoma expansion group (HE group) and hematomoma unexpanded group (non-HE group) (Table 1)Table 1The clinical data of ich hematoma expansion group and patients in the hematoma-expanded group were comparedNote: HE, hematoma enlargement; SD, standard deviation; SBP, systolic pressure; DBP, diastolic pressure; PLT, platelets; PT, clotting enzyme progenitor time; aPTT, activated part of the clotting enzyme kinase time; INR, international standardization ratio; IQR, quadranged range; GCS, Glasgow coma scale; HICH, hypertensive brain hemorrhage; CT, computer tomography single-variable and multivariate logistic regression analysis found that the serum iCa was 1.10 mmol/L when the hematoma was enlarged and the patient was admitted to the hospital, and the hematoma did not expand to 1.17 mmol/L The single-variable analysis showed a significant difference in GCS score, initial HICH volume, iCa and tCa water averages between HE and non-HE groups (P 0.05) In multivariate logistic regression analysis, iCa emis (serum iCa s.12mmol/L) (OR s.300; 95% CI, 0.095-0.951) and early hematoma The expansion was associated with iCa emis (serum iCa s.12mmol/L) (OR s.192; 95% CI, 0.067-0.554) was also associated with poor prognosis in patients , the reduction of serum free ion calcium levels during admission was related to the early expansion of cerebral hemorrhage hematoma hypertension, and the total calcium in the serum had little effect on the prognosis Therefore, it is recommended that patients with cerebral hemorrhage with hypertension test blood gas analysis during admission to determine the level of serum free ion calcium, which can help to assess the risk of rebleeding (First Hospital of Fuzhou Serena compiled, Liu Chonghong, of the First People's Hospital in Changshu City, Jiangsu Province, review school, editor-in-chief of "Outside The Outside Information" and professor of Chen Quancheng , a subsidiary of Fudan University.