Analysis Of Risk Factors For The First Occurrence Of Hyponatremia In Hypertensive Intracerebral Hemorrhage

Objective:Hypertensive intracerebral hemorrhage is a common disease encountered in the daily work of neurosurgery due to its high disability rate and fatality rate.The disease can cause a variety of complications（lung infection,gastrointestinal bleeding and hyponatremia,etc.）,and hyponatremia is one of the most common and serious complications,mild hyponatremia can cause fatigue,weekness,temperament change,serious cases can cause consciousness disorders,epilepsy,and even malignant arrhythmia and aggravated brain edema resulting in cerebral hernia and death.It is an important cause of disability and death in patients with hypertensive cerebral hemorrhage.This study retrospectively analyzed the cases of hypertensive cerebral hemorrhage complicated with hyponatremia for the first time,and discussed the related risk factors,so as to help clinicians timely judge the changes of patients’conditions and guide treatment,so as to reduce the incidence of hyponatremia in hypertensive cerebral hemorrhage patients and reduce the disability rate and mortality rate of patients.Methods:This study mainly collected and retrospectively analyzed the data of hypertensive intracerebral hemorrhage patients admitted to Kunming First People’s Hospital from December 2017 to December 2020 Patients with hypertensive intracerebral hemorrhage were divided into hyponatremia group and non-hyponatremia group based on whether they were complicated with hyponatremia after admission.The gender,age,classification of bleeding sites,whether they had broken into the cerebral ventricle,calculation of intracranial hematoma volume under brain CT imaging,systolic and diastolic blood pressure,whether to undergo surgery before diagnosis of hyponatremia,blood routine tests,and biochemical indicators related to liver and kidney function were recorded The admission GCS score（15points for clear consciousness,12-14 points for mild disturbance of consciousness,9-11 points for moderate disturbance of consciousness,3-8 points for coma）,and the discharge m RS score（0-1 points for good prognosis,2-5 points for poor prognosis）.SPSS 26.0 software was used for statistical analysis to conduct a single factor analysis of the risk factors of hypertensive intracerebral hemorrhage complicated with hyponatremia for the first time.The significant factors in the single factor analysis were then included in a multiple linear regression model for testing.A difference of P<0.05 was statistically significant.To explore the risk factors associated with hyponatremia following hypertensive intracerebral hemorrhage for the first time,in order to help clinicians timely grasp the changes in the patient’s condition and take active treatment measures.Results:1.A total of 215 cases were included in the study:69 in the low sodium group and 146 in the non-low sodium group.The incidence of hyponatremia was32.09%.2.The univariate analysis results showed:the systolic blood pressure,gender,age,Mg²⁺,RBC,HGB,HCT,MCV,MCH,PCT,MCHC,RDW-SD,RDW-CV,PLT,WBC,MPV,MPLT,PDW,NEUT%,EO,ALB,EO%,NEUT,BASO,TP,GLB,A/G,AST,TBIL,IBIL,ALT,L/S,GGT,ALP,GLU,Urea,CREA,P,K⁺,e GFR,whether to break into the ventricle and admission GCS score had no significant difference between hypertensive intracerebral hemorrhage and hyponatremia（P>0.05）;Computed intracranial hematoma volume,diastolic blood pressure,LYMPH%,MONO%,BASO%,LYMPH,MONO,DBIL,UA,Ca²⁺,Cl^-,whether to undergo surgery before diagnosis of hyponatremia and the m RS score at discharge had a significant difference in the occurrence of hyponatremia for the first time between hypertensive intracerebral hemorrhage and hypertensive intracerebral hemorrhage（P<0.05）.3.The results of multivariate binary logistic regression analysis showed that there was a statistically significant difference between the calculated amount of intracranial hematoma under brain CT images,DBIL,UA,Ca²⁺,Cl^-,and the occurrence of hyponatremia in hypertensive intracerebral hemorrhage for the first time（P<0.05）;There was no statistically significant difference between the other independent variables and seizures（P>0.05）.Conclusions:This article conducts a retrospective study on the relevant risk factors of hyponatremia in patients with hypertensive intracerebral hemorrhage for the first time,and more accurately and comprehensively obtains the relevant risk factors affecting hyponatremia in patients with hypertensive intracerebral hemorrhage without excluding relevant interfering factors:1.Univariate analysis verified that the calculated intracranial hematoma volume,diastolic blood pressure,LYMPH%,MONO%,LYMPH,MONO,DBIL,UA,Ca²⁺,Cl^-,whether to perform surgery before diagnosis of hyponatremia,and the m RS score at discharge were risk factors for the first occurrence of hyponatremia in hypertensive intracerebral hemorrhage;2.Multivariate analysis showed that the calculated amount of intracranial hematoma under brain CT imaging,DBIL,UA,Ca²⁺,Cl^-were independent risk factors for the first occurrence of hyponatremia in hypertensive intracerebral hemorrhage.This study is conducive to early prevention,diagnosis,and timely intervention of these risk factors in clinical practice,thereby improving the prognosis of patients with hypertensive intracerebral hemorrhage.