蛛网膜下腔出血患者继发症状性脑血管痉挛的相关危险因素分析  

Analysis of Risk Factors in Symptomatic Cerebral Vasospasm after Subarachnoid Hemorrhage

作　　者：张铃铛[1] 宋毅[1] 冯清林[1] 刘明冬[1] 范仕兵[1] 杜江峰[1] 张鹏[1] 冯梅[1] 

机构地区：[1]重庆三峡中心医院神经外科,重庆404000

出　　处：《中国卒中杂志》2014年第5期394-398,共5页Chinese Journal of Stroke

摘　　要：目的研究探讨动脉瘤性蛛网膜下腔出血(subarachnoid hemorrhage,SAH)继发症状性脑血管痉挛(symptomatic cerebral vasospasm,SCVS)的相关危险因素,为SCVS的防治提供参考。方法回顾性分析96例SAH患者临床资料,对性别、年龄、高血压史、糖尿病史、Fisher分级等影响因素进行统计学分析。结果 96例患者中发生SCVS的患者共39例,单因素分析结果显示SCVS组与非SCVS组在年龄、高血压、吸烟、脑室内积血、Hunt-Hess分级、Fisher分级、数字减影血管造影(digital subtraction angiography,DSA)显示血管痉挛程度、尼莫地平使用等方面差异有显著性;多因素Logistic回归分析结果显示:低龄、高血压史、Fisher分级是发生SCVS的危险因素,其比值比(odds ratio,OR)分别为0.567、1.982和2.713;而尼莫地平的使用是SCVS发生的保护因素,OR为0.799。结论 SAH后SCVS是多种因素共同作用的结果,其中低年龄、高血压史、Fisher分级是SCVS的独立危险因素,尼莫地平使用为保护因素。Objective To explore the risk factors for cerebral symptomatic vasospasm following subarachnoid hemorrhage（SAH）, and provide reference for the prevention and treatment of symptomatic cerebral vasospasm（SCVS）.Methods The clinical data of 96 SAH patients were retrospectively analyzed, and the risk factors such as gender, age, history of hypertension, history of diabetes, modified Fisher grades were statistically analyzed.Results Of all 96 patients, 39 were found SCVS. There were statistical differences in age, history of hypertension, cigarette smoking, intraventricular hemorrhage, Hunter-Hess grade, modified Fisher grades, the degree of vasospasm, and the use of nimodipine between the group of SCVS and the group of non-SCVS by univariate analysis. Logistic regression analysis demonstrates that lower age, history of hypertension, modified Fisher grades are the risk factors of SCVS, and the value of their ORs are 0.567, 1.982, 2.713, respectively. The use of nimodipine is the conservancy factor, and the value of its OR is 0.799.Conclusion SCVS after SAH is the result of co-action of multiple factors. The age, history of hypertension, modified Fisher grades, and the use of nimodipine are independent risk factors. Early detection and treatment should be strengthened.

关 键 词：蛛网膜下腔出血 症状性脑血管痉挛 危险因素 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R743.35[医药卫生—临床医学]