腰穿脑脊液测压在自发性颅内低压性头痛的价值再评估  

Reassessment of the value of cerebrospinal fluid pressure through lumbar puncture in patients with headache due to spontaneous intracranial hypotension

作　　者：叶碧军 刘耀文 杨怡[1] 胡兴越[1] YE Bijun;LIU Yaowen;YANG Yi(Department of Neurology,SirRun Run Shaw Hospital,Zhejiang University School of Medicine,Hangzhou 310016,China)

机构地区：[1]浙江大学医学院附属邵逸夫医院神经内科,浙江杭州310016 [2]浙江省天台县人民医院神经内科

出　　处：《全科医学临床与教育》2019年第1期24-26,共3页Clinical Education of General Practice

摘　　要：目的观察自发性颅内低压(SIH)患者中脑脊液压力,并探讨影响SIH患者的脑脊液压力的相关因素。方法收集194例SIH患者临床和影像资料,分析性别、年龄、血压、体重指数(BMI)、病程、脑脊液蛋白含量、头颅MRI增强表现、脑脊液漏点、硬膜下血肿与脑脊液压力的相关性。结果 194例患者中,共有93(47.94%)例患者的脑脊液压力≤60 mmH_2O,101(52.06%)例患者的脑脊液压力>60 mmH_2O。相关性分析显示:SIH患者病程、年龄、收缩压、BMI、性别、脑脊液蛋白含量、头颅MRI增强表现阳性及脑脊液漏点与脑脊液压力相关(r分别=0.47、0.17、0.19、0.21、-0.21、-0.40、-0.16、-0.19,P均<0.05)。多元线性回归分析显示,仅病程和脑脊液蛋白含量与脑脊液压力存在相关性(t分别=-2.59、2.41,P均<0.05)。结论 SIH患者的脑脊液压力不一定都低于60 mmH_2O。SIH患者的脑脊液压力与病程和脑脊液蛋白含量相关。Objective To observe cerebrospinal fluid pressure in patients with spontaneous intracranial hypotension(SIH)and explore the factors of the cerebrospinal fluid pressure.Methods Clinical and imaging materials of 194 SIH patients were collected to analyze the relationship between the factors including gender,age,blood pressure,BMI,course of disease,CSF protein content,cephalic contrast-enhanced MRI,CSF leakage lesions and subdural hematoma and CSF pressure.Results Of 194 patients,93(47.94%)cases had cerebrospinal fluid pressure lower than 60 mmH2O and 101(52.06%)cases had cerebrospinal fluid pressure higher than 60 mmH2O.Correlation analysis showed that CSF pressure were correlated with the course of disease,age,systolic pressure,BMI,gender,CSF protein content,cephalic contrastenhanced MRI and CSF leakage lesions(r=0.47,0.17,0.19,0.21,-0.21,-0.40,-0.16,-0.19,P<0.05).Multiple linear regression analysis showed that the course of disease and the content of CSF protein were related with CSF pressure(t=-2.59,2.41,P<0.05).Conclusions The cerebrospinal fluid pressure of SIH patients is not necessarily lower than 60 mmH2O.Cerebrospinal fluid pressure in patients with SIH is correlated with course of disease and CSF protein content.

关 键 词：颅内低压 脑脊液压力 病程 脑脊液蛋白 

分 类 号：R741.041[医药卫生—神经病学与精神病学]