CT平扫非均一密度血肿与原发性基底节区脑出血患者预后的关系

摘要
图/表
参考文献(22)
相关文章 (15)

全文: PDF (721 KB) HTML (1 KB)
输出: BibTeX | EndNote (RIS)

摘要目的探讨CT平扫非均一密度血肿与原发性基底节区脑出血患者临床预后的关系。方法选择2014年1月～2018年10月安徽省芜湖市第一人民医院收治的原发性基底节区脑出血6 h内患者146例，根据患者改良Rankin量表（mRS）将其分为预后良好组（0～2分）77例和预后不良组（3～6分）69例；采用单因素方差分析及多因素Logistic回归分析筛选不良临床预后的危险因素。结果预后不良组患者入院时收缩压、基线美国国立卫生研究院卒中量表（NIHSS）评分、非均一密度血肿阳性率、血肿混杂征阳性率、血肿黑洞征阳性率、早期神经功能恶化率、血肿扩大率、3周NIHSS评分、mRS评分均高于预后良好组，而首次CT完成时间短于预后良好组，基线血肿体积大于预后良好组，差异均有统计学意义（均P ＜ 0.05）。非均一密度血肿阳性和入院时收缩压均是基底节区脑出血患者血肿扩大、早期神经功能恶化及6个月不良预后的影响因素（P ＜ 0.05）。结论 CT非均一密度血肿（黑洞征或混杂征）是自发性脑出血预后不良的危险因素。

	服务

	把本文推荐给朋友
	加入我的书架
	加入引用管理器
	E-mail Alert
	RSS
	作者相关文章
	何敏1 陈后勤1 邵凌云1 左键1 韩江全2

关键词 ：脑出血, 黑洞征, 混杂征, 非均一密度血肿, 临床预后

Abstract：Objective To explore the relationship between non-uniform density hematoma on plain CT scan and the clinical prognosis of patients with primary cerebral hemorrhage in basal ganglia. Methods From January 2014 to October 2018, a total of 146 patients with primary cerebral hemorrhage in basal ganglia and within 6 h admitted to Wuhu NO.1 People′s Hospital were selected. According to the modified Rankin Scale (mRS), they were divided into 77 patients of good clinical prognosis group (0-2 points) and 69 patients of poor prognosis group (3-6 points). One-way ANOVA and multivariate Logistic regression analysis were used to screen risk factors for poor clinical prognosis. Results The systolic blood pressure on admission, baseline of the national institutes of health stroke scale (NIHSS) scores, positive rate of non-uniform density hematoma, positive rate of hematoma mixed character, positive rate of hematoma black holes), rate of early neurologic deterioration, hematoma expansion rate, 3 weeks NIHSS score, mRS score in poor prognosis group were higher than those in good prognosis group, while the computed tomography (CT) for the first time and completion time is shorter than good prognosis group, baseline hematoma volume was larger than good prognosis group, the differences were statistically significant (all P ＜ 0.05). Positive rate of non-uniform density hematoma and systolic blood pressure at admission were influencing factors of hematoma enlargement, early deterioration of neurological function and poor prognosis at 6 months in patients with cerebral hemorrhage at basal ganglia (P ＜ 0.05). Conclusion CT non-uniform density hematoma (black hole sign or blend sign) is an risk factor for poor prognosis of spontaneous cerebral hemorrhage.

Key words： Cerebral hemorrhage Black hole sign Blend Sign Non-uniform density hematoma Clinical prognosis

基金资助:安徽省芜湖市“十三五”医学重点专科资助项目。

通讯作者: 韩江全（1966.10-），男，硕士，教授，主任医师，硕士生导师；研究方向：脑血管病。

作者简介: 何敏（1982.10-），女，硕士；研究方向：脑血管病。

引用本文:

何敏1 陈后勤1 邵凌云1 左键1 韩江全2. CT平扫非均一密度血肿与原发性基底节区脑出血患者预后的关系[J]. 中国医药导报, 2019, 16(27): 184-188.
HE Min1 CHEN Houqin1 SHAO Lingyun1 ZUO Jian1 HAN Jiangquan2. Relationship CT scan non-uniform density hematoma and clinical prognosis of patients with primary cerebral hemorrhage in basal ganglia between on plain. 中国医药导报, 2019, 16(27): 184-188.

链接本文:

http://www.yiyaodaobao.com.cn/CN/ 或 http://www.yiyaodaobao.com.cn/CN/Y2019/V16/I27/184

[1] Van Asch CJ，Luitse MJ，Rinkel GJ，et al. Incidence，case fatality，and functional outcome of intracerebral haemorrhage over time，according to age，sex，and ethnic origin：a systematic review and meta-analysis [J]. Lancet Neurol. 2010，9（2）：167-176.
[2] Barras CD，Tress BM，Christensen S，et al. Quantitative CT Densitometry for Predicting Intracerebral Hemorrhage Growth [J]. AJNR Am J Neuroradiol，2013，34（6）：1139-1144.
[3] de Oliveira Manoel AL，Goffi A，Zampieri FG，et al. The critical care management of spontaneous intracranial hemorrhage：a contemporary review [J]. Crit Care，2016，20（1）：272.
[4] Li Q，Zhang G，Huang YJ，et al. Blend Sign on Computed Tomography Novel and Reliable Predictor for Early Hematoma Growth in Patients With Intracerebral Hemorrhage [J]. Stroke，2015，46（8）：2119-2123.
[5] Li Q，Zhang G，Xiong X，et al. Black Hole Sign Novel Imaging Marker That Predicts Hematoma Growth in Patients With Intracerebral Hemorrhage [J]. Stroke，2016，47（7）：1777-1781.
[6] 高子丹，褚鹤龄，杨晓波，等.预测急性脑出血后血肿增大的影像学征象[J].国际脑血管病杂志，2016，24（7）：623-627.
[7] Feigin V，Lawes C，Bennett D，et al. Worldwide stroke incidence and early case fatality reported in 56 population-based studies：a systematic review [J]. Lancet Neurology，2009，8（4）：355-369.
[8] Liotta EM，Prabhakaran S，Sangha RS，et al. Magnesium，hemostasis，and outcomes in patients with intracerebral hemorrhage [J]. Neurology，2017，89（8）：813-819.
[9] Mayer SA，Sacco RL，Shi T，et al. Neurologic deterioration in noncomatose patients with supratentorial intracerebral hemorrhage [J]. Neurology，1994，44（8）：1379-1384.
[10] 中华医学会神经病学分会，中华医学会神经病学分会脑血管病学组.中国脑出血诊治指南（2014）[J].中华神经科杂志，2015，48（6）：435-444.
[11] Kothari RU，Brott T，Broderiek JP，et al. The ABCs of measuring intracerebral hemorrhage volumes [J]. Stroke，1996，27（8）：1304-1305.
[12] 谈颂，常思远，宋波，等.早期改良美国国立卫生研究院卒中量表评分对缺血性卒中预后的预测作用[J].中华神经科杂志，2012，45（3）：154-157.
[13] 孙冲，徐迪荣，李碧磊.改良Rankin量表在急性大面积脑梗死长期生存的预后价值[J].医学研究杂志，2012， 41（12）：179-182.
[14] 钱新宇，吕金峰，Muhammad B，等.急性脑梗死静脉溶栓后早期神经功能恶化与血清白蛋白水平的关系研究[J].中国医师进修杂志，2019，42（4）：318-324.
[15] Christen D. Barras，Brian M. Density and Shape as CT Predictors of Intracerebral Hemorrhage Growth [J]. Stroke. 2009，40（4）：1325-1331.
[16] Wada R，Aviv RI，Fox AJ，et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage [J]. Stroke，2007，38（4）：1257-1262.
[17] Miyahara M，Noda R，Yamaguchi S，et al. New prediction score for hematoma expansion and neurological deterioration after spontaneous intracerebral hemorrhage：A Hospital·Based Retrospective Cohort Study [J]. J Stroke Cerebrovasc Dis，2018，27（9）：2543-2550
[18] Veltkamp R Purrucker J. Management ofspontaneous intracerebral hemorrhage [J]. Curr Neurol Neurosci Rep，2017，17（10）：80.
[19] Magaki SD，Williams CK，VintersHV. Glial function（and dysfunction） in the normal &ischemic brain [J]. Neuropharmacology，2018，134（Pt B）：218-225.
[20] Sakuta K，Sato T，Komatsu T，et al. 111e NAG scale：noble predictive scale for hematoma expansion in intracerebral hemorrhage [J]. J Stroke Cerebrovasc Dis，2018， 27（10）：2606-2612.
[21] 刘佳霖，王革生，李楠楠，等.立体定向手术治疗高血压性脑出血的效果[J].中国医药导报，2017，14（32）：71-74.
[22] 张斌，周家强，何惟高，等.甘露醇在控制高血压性脑出血患者早期血肿扩大中的影响评估[J].中国现代医生，2017，55（13）：7-10.