脑微出血与老年高血压性脑出血血肿扩大的相关性研究  

Relationship of cerebral microbleeds with hematoma growth in elderly patients with acute hypertensive intracerebral hemorrhage

作　　者：刘首峰[1] 李玉旺[1] 王欣[1] 徐小林[1] 

机构地区：[1]天津市环湖医院神经内科,300060

出　　处：《中国现代神经疾病杂志》2015年第1期53-56,共4页Chinese Journal of Contemporary Neurology and Neurosurgery

基　　金：天津市科技支撑重点项目(项目编号:13ZCZDSY01600);天津市卫生局科技基金资助项目(项目编号:2012KZ033)~~

摘　　要：目的探讨脑微出血对老年高血压性脑出血血肿扩大的预测作用。方法采用磁敏感加权成像对98例老年高血压性脑出血患者进行脑微出血灶观察,据发病后24 h头部CT血肿扩大和实验室指标变化,采用多因素Logistic回归分析评价脑微出血对脑出血后血肿扩大的预测价值。结果 98例患者中25例于发病后24 h复查CT显示血肿扩大,发生率约为25.51%,脑微出血组为43.75%（14/32）,高于非脑微出血组的16.67%（11/66;χ2=8.319,P=0.004）。多因素Logistic回归分析显示,脑微出血为老年高血压性脑出血血肿扩大的独立影响因素（OR=0.241,95%CI：0.065~0.861;P=0.017）。结论老年高血压性脑出血急性期（24 h）合并脑微出血患者血肿扩大风险明显增加,应及时采取相关预防措施以改善预后。Objective To investigate whether cerebral microbleeds（CMBs） can predict hematomagrowth in elderly patients with acute hypertensive intracerebral hemorrhage.Methods The clinical records of 98 elderly patients with acute hypertensive intracerebral hemorrhage who underwent initial CTwithin 6 h and repeated CT and susceptibility-weighted imaging（SWI） within 24h of onset were analyzed.Based on the performance of SWI, patients were divided into microbleeds group and non-microbleeds group.Forward multivariate Logistic regression analysis was used to evaluate the predicting value of CMBs on thegrowth of intracerebral hematoma.Results Among 98 patients, hematoma growth was found in 25 casesin the second CT scan. The ratio in microbleeds group was significantly higher than that in non-microbleeds group（43.75% vs 16.67%; χ2= 8.319, P = 0.004）. Multivariate Logistic regression showed that CMBs was independent risk factor for intracerebral hematoma（OR = 0.241, 95%CI： 0.065-0.861; P = 0.017）.Conclusions CMBs in patients with acute intracerebral hematoma can predict high risk of hemotoma growth, and effective treatment should be taken to improve the prognosis of patients.

关 键 词：颅内出血 高血压性 磁共振成像 回归分析 老年人 

分 类 号：R743.34[医药卫生—神经病学与精神病学]