脑静脉窦血栓形成转归的预测因素——26例回顾性病例系列研究  

Predictive factors of the outcome of cerebral venous sinus thrombsis a retrospective ,case series study of 26 patients

作　　者：王中原[1] 李敬伟[2] 庞伟[3] 徐运[1,2] 

机构地区：[1]南京中医药大学中西医结合鼓楼临床医学院神经内科,210008 [2]南京大学医学院附属鼓楼医院神经内科,210008 [3]南京鼓楼医院集团宿迁市人民医院神经内科,宿迁223800

出　　处：《国际脑血管病杂志》2011年第10期758-762,共5页International Journal of Cerebrovascular Diseases

基　　金：国家自然科学青年基金（81000510）;江苏省自然科学基金（BK2009037）

摘　　要：目的探讨脑静脉窦血栓形成 （ cerebral venous sinus thrombosis, CVST）远期转归的预测因素。方法回顾性分析26例CVST患者的临床资料，在发病后6个月应用改良Rankin量表（modified Rankin Scale，mRS）评分评价临床转归。单变量和多变量分析确定远期转归不良的独立预测因素。结果26例CVST患者mRS评分：0～1分19例，2分2例，3～5分3例，692例。19．2％的患者转归不良（mRS评分≥3分），病死率为7．7％，存活患者在6个月内均无复发。单变量分析显示，意识障碍、视盘水肿、脑水肿和脑深静脉血栓形成为转归不良的可能危险因素，而以头痛为主要表现与预后不良呈负相关。多变量回归分析表明，意识障碍是CVST患者转归不良的独立预测因素（优势比48．0，95％可信区间2．311～997．176；P=0．012）。结论CVST患者远期转归较好，起病时意识障碍为发病后6个月时转归不良的独立预测因素。Objective To investigate the predictive factors of long-term outcome of cerebral venous sinus thrombosis （CVST）. Methods The clinical data of 26 patients with CVST were analyzed retrospectively. The clinical outcome was assessed with the modified Rankin Scale （mRS） at 6 months after symptom onset. Univariate and multivariate analysis were used to determine the independent predictors of the long-term poor outcome. Results The mRS scores for 26 patients with CVST： 0 to 1 in 19 cases, 2 in 2 cases, 3 to 5 in 3 cases, and 6 in 2 cases. 19.2% of patients had poor outcome （mRS score, ≥3）, and the mortality rate was 7.7%. The survivors did not have any recurrence within 6 months. Univariate analysis showed that disturbance of consciousness, papiUoedema, cerebral edema, and cerebral deep venous thrombosis were the possible risk factors for poor outcome, while headache was the main clinical manifestation, which was negatively correlated with the poor prognosis. Multivariate regression analysis showed that disturbance of consciousness was an independent predictor of poor outcome in patients with CVST （odds ratio, 48.0, 95% confidence interval 2. 311 to 997. 176, P =0. 012）. Conclusions The long-term outcome of the patients was better, disturbance of consciousness was an independent predictor of poor outcome at 6 months after the onset.

关 键 词：窦血栓形成 颅内 脑静脉 静脉血栓形成 颅内血栓形成 预后 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学]