41例脑转移瘤出血性瘤卒中的相关临床因素分析  

Risk Factors of Hemorrhagic Stroke in 41 Patients with Metastatic Brain Tumors

作　　者：曹建平 孙鹏 谷春雨[1] 王浩然[1] 张宏伟[1] 曲彦明[1] 宁威海 于春江[1] 张明山[1] CAO Jian-ping;SUN Peng;GU Chun-yu;WANG Hao-ran;ZHANG Hong-wei;QU Yan-ming;NING Wei-hai;YU Chun-jiang;ZHANG Ming-shan(Sanbo Brain Hospital,Capital Medical University,Beijing 100093,China)

机构地区：[1]首都医科大学三博脑科医院,北京100093

出　　处：《肿瘤学杂志》2023年第4期308-313,共6页Journal of Chinese Oncology

基　　金：北京市海淀区卫生健康发展科研培育计划(HP2021-04-50803)

摘　　要：[目的]探讨脑转移瘤出血性瘤卒中发生的相关因素及临床特点。[方法]回顾性分析2014年1月至2021年6月在首都医科大学三博脑科医院经手术切除、病理证实的脑转移患者共278例,其中41例出血性瘤卒中患者(卒中组),237例无出血性瘤卒中(对照组)。单因素分析采用卡方或Mann-Whitney U检验,多因素分析采用二元Logistic回归分析,分析瘤卒中的危险因素。[结果]脑转移瘤瘤卒中率为14.7%,不同来源肿瘤卒中率:黑色素瘤39.3%、肾癌15.8%、肺癌15.7%、乳腺癌3.4%。单因素分析显示不同病理类型、肿瘤质地、转移瘤数目、是否放疗与瘤卒中率有关(P均<0.05),多因素分析显示黑色素瘤相比肺癌(P=0.015)、实性肿瘤(P=0.019)、接受放疗(P=0.040)是发生出血性瘤卒中的独立危险因素。[结论]实性脑转移肿瘤、接受放疗可增加脑转移瘤瘤内出血风险。转移瘤卒中出血的诊断主要依靠术中诊断。[Objective]To investigate the risk factors of hemorrhagic stroke in patients with metastatic brain tumors.[Methods]A total of 278 patients with metastatic brain tumors who underwent craniotomy and confirmed by pathology at Sanbo Brain Hospital,Capital Medical University between January 2014 and June 2021 were enrolled,including 41 cases with hemorrhagic brain metastases(hemorrhage group)and 237 cases without intratumoral hemorrhage(control group).The risk factors for hemorrhagic stroke were analyzed by univariable analysis and multivariate Logistic regression analysis.[Results]The incidence of hemorrhagic stroke in this series was 14.7%(41/278);the incidence in melanoma was 39.3%,renal carcinoma was 15.8%,lung cancer was 15.7%and breast cancer was 3.4%.The univariate analysis showed that the intratumoral hemorrhage was significantly associated with histology types,tumor texture,number metastatic foci,and radiotherapy(all P<0.05).The multivariate analysis showed that melanoma(P=0.015),solid tumor(P=0.019)and radiotherapy(P=0.040)were independent risk factors for intratumoral hemorrhage.[Conclusion]The study shows that metastatic melanoma has high risk of brain hemorrhagic stroke;and the solid tumor and radiotherapy also increase the risk of brain metastatic intratumoral hemorrhage.

关 键 词：脑转移瘤 脑肿瘤卒中 瘤内出血 危险因素 

分 类 号：R739.41[医药卫生—肿瘤]