非高血压性自发性脑出血患者的临床特征及DSA分析  

EPIDEMIOLOGICAL FEATURES AND DSA ANALYSIS OF PATIENTS WITH NON-HYPERTENSIVE SPONTANEOUS INTRACEREBRAL HEMORRHAGE IN TANGSHAN

作　　者：贾叶华 张宏义 王景丰 刘科 Jia Yehua;Zhang Hongyi;Wang Jingfeng(Neurosurgery Department,Tangshan Workers Hospital,Tangshan 063000,China)

机构地区：[1]河北省唐山市工人医院神经外科,063000

出　　处：《中国煤炭工业医学杂志》2020年第5期477-481,共5页Chinese Journal of Coal Industry Medicine

基　　金：河北省卫生和计划生育委员会(编号:20160844)。

摘　　要：目的基于数字减影血管造影(digital subtraction angiography,DSA)结果分析唐山地区非高血压性自发性脑出血(intracerebral hemorrhage,ICH)患者临床特征。方法选取该院2018年1月—2019年12月收治的符合纳入与排除标准的1200例非自发性ICH患者,参照DSA检查结果,依据病因分组,分析不同病因的非高血压ICH患者的临床特征。结果1200例非高血压性ICH患者中脑动静脉畸形(arteriovenous malformations,AVM)671例、脑动脉瘤235例、血管淀粉样变致脑出血(hemorrhage related to cerebral amyloid angiopathy,CAAH)166例、口服抗凝药相关性脑出血(oral anticoagulanttherapy related intracerebral hemorrhage,OAC-ICH)87例、血液病19例、脑肿瘤卒中22例;其中男性比例57.58%、女性42.42%,且不同病因的非高血压性ICH患者性别分布差异无统计学意义(P>0.05);同时,1200例非高血压性ICH患者中,20~岁比例最高,其次为40~岁、<20岁;发病季节以冬季发病比例最高,为46.17%,其次为春季,夏秋季相对低发;出血部位以蛛网膜下腔及脑叶出血比例最高,为46.75%(561/1200),其次为基底节区出血,比例为25.42%(305/1200);且不同病因患者年龄、发病季节及出血部位分布差异均有统计学意义(均P<0.05)。结论非高血压性ICH患者病因多为AVM、脑动脉瘤,且在年龄、发病季节及出血部位上可依据病因不同呈现明显差异性分布。Objective To analyze epidemiological features of patients with non-hypertensive spontaneous intracerebral hemorrhage(ICH)in Tangshan based on digital subtraction angiography(DSA)results.Methods The study subjects were from one thousand two hundred non-spontaneous ICH patients who met inclusion and exclusion criteria and were admitted to Tangshan Workers Hospital from January 2018 to December 2019.DSA test results were referred to,grouping was conducted according to disease causes.Epidemiological features of non-hypertensive ICH patients with different disease causes were analyzed.Results In 1,200 non-hypertensive ICH patients,there were 671 cases with arteriovenous malformations(AVM),235 cases with cerebral aneurysms,166 cases with hemorrhage related to cerebral amyloid angiopathy(CAAH),87 cases with oral anticoagulanttherapy related intracerebral hemorrhage(OAC-ICH),19 cases with hemopathy and 22 cases with cerebral tumor stroke.The ratios of male and female were 57.58%and 42.42%,respectively.There was no significant difference in gender distribution among non-hypertensive ICH patients with different disease causes(P>0.05).In 1,200 non-hypertensive ICH patients,proportion of patients aged 20 years old was the highest,followed by older than 40 years old and less than 20 years old.The incidence was highest in winter(46.17%),followed by spring.The incidence was relatively lower in summer and autumn.The hemorrhage site rate of cerebral lobe hemorrhage was the highest(46.75%(561/1,200)),followed by basal nucleus(25.42%(305/1,200)).There were significant differences in age,onset season and distribution of hemorrhage sites among patients with different disease causes(P<0.05).Conclusion The disease causes of non-hypertensive ICH patients are mostly AVM and cerebral aneurysm.There are significant differences in age,onset season and hemorrhage sites among patients with different disease causes.

关 键 词：非高血压性自发性脑出血 临床特征 数字减影血管造影 

分 类 号：R743.35[医药卫生—神经病学与精神病学]