成人出血型脑底异常血管网症短期预后不良的危险因素分析  

Risk factors for poor short-term prognoses in adult patients with hemorrhagic moyamoya disease

作　　者：张妮[1] 徐佳[1] 韦永祥[1] ZHANG Ni;XU Jia;WEI Yong-xiang(Department of Neurosurgery,Drum Tower Hospital,School of Medicine,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院神经外科,南京210008

出　　处：《中国临床神经外科杂志》2021年第11期842-844,852,共4页Chinese Journal of Clinical Neurosurgery

基　　金：江苏省人社厅-省博士后基金(1501122B);江苏省南京市卫计委重点项目(ZKX15014);江苏省南京市卫生科技发展专项资金项目(YKK18057)。

摘　　要：目的探讨成人出血型脑底异常血管网症(MMD)短期预后不良的危险因素。方法回顾性分析2018年1月至2020年1月收治的122例出血型MMD的临床资料。根据出院时改良Rankin量表评分评估短期预后,0~2分为预后良好,≥3分为预后不良。采用多因素logistic回归分析短期预后不良的危险因素。结果出院时,122例中,预后不良66例,预后良好56例。多因素logistic回归分析结果显示,入院GCS评分≤9分、脑积水、脑内出血、蛛网膜下腔出血及中线位移≥5 mm为出血性MMD短期预后不良的独立危险因素(P<0.05)。结论对于出血型MMD,入院时GCS评分、脑积水、脑实质内出血、蛛网膜下腔出血及中线移位等是短期预后不良的评估指标。Objective To investigate the risk factors for poor short-term prognoses in the adult patients with hemorrhagic moyamoya disease(MMD).Methods The clinical data of 122 patients with hemorrhagic MMD who were admitted to our hospital from January 2018 to January 2020 were retrospectively analyzed.The short-term prognosis was evaluated according to the modified Rankin scale score on discharge,with score of 0~2 as good prognosis and score≥3 as poor prognosis.Multivariate logistic regression was used to analyze the risk factors for poor short-term prognoses in the patients with hemorrhagic MMD.Results Of 122 MMD patients,66 had a poor short-term prognosis and 56 had a good prognosis.Multivariate logistic regression analysis showed that GCS score on admission≤9,hydrocephalus,cerebral hemorrhage,subarachnoid hemorrhage,and midline shift≥5 mm were independent risk factors for poor shortterm prognoses in the patients with hemorrhagic MMD(P<0.05).Conclusions For adult patients with hemorrhagic MMD,GCS score on admission,hydrocephalus,cerebral hemorrhage,subarachnoid hemorrhage and midline shift are indicators of poor short-term prognosis.

关 键 词：出血型烟雾病 成年人 短期预后 危险因素 

分 类 号：R743[医药卫生—神经病学与精神病学]