脑转移瘤内出血的多因素分析  

The Analysis of Risk Factors of Brain Metastases Apoplexy

作　　者：郑眉光[1] 李文鹏 邱儒彬 刘正豪[1] 邓跃飞[1] ZHENG Mei-guang;LI Wen-peng;QIU Ru-bin;LIU Zheng-hao;DENG Yue-fei(Department of neurosurgery,Sun Yat-sen Memorial Hospital of Sun Yat-sen University,Guangzhou,510080)

机构地区：[1]中山大学孙逸仙纪念医院神经外科,510080

出　　处：《岭南急诊医学杂志》2022年第5期438-441,共4页Lingnan Journal of Emergency Medicine

摘　　要：目的:探讨与脑转移瘤内出血相关的因素,为脑转移瘤患者的准确诊断提供理论依据。方法:回顾性分析2012年2月至2021年12月在中山大学孙逸仙纪念医院经病理证实的264例脑转移瘤患者的临床资料,包括性别、年龄、高血压/糖尿病史、抗凝/抗板药物使用史、脑转移瘤的部位、最大径、是否多发、是否他处转移、原发肿瘤病理类型、颅内肿瘤病理类型、颅内转移瘤的ki⁃67指数、D二聚体、白蛋白、乳酸脱氢酶等。采用两独立样本t检验及卡方检验筛选可能引起脑转移瘤出血的危险因素,并进一步运用多因素Logistic回归模型进行独立因素的筛选。结果:264例脑转移瘤中33例发生肿瘤内出血(12.5%),其中肺癌脑转移出血最常见(13/33),其次是肝癌(6/33),肝癌脑转移发生出血的风险最高(6/8)。高血压、原发肿瘤的病理类型为肝细胞癌、转移灶位于大脑半球是脑转移瘤出血的独立危险因素。结论:脑转移瘤内出血和多种危险因素相关,早期识别其危险因素并积极干预,有助于减少脑转移瘤出血的发生,改善脑转移瘤患者的预后。Objective:To explore the risk factors associated with brain metastases apoplexy,in order to provide theoretical evidence about precision approach for patients with brain metastasis.Methods:We analyzed the clinical data of 264 patients with pathologically confirmed intracranial metastases,including sex,age,history of hypertension/diabetes mellitus,history of anticoagulant/antiplate drug use,pathological type of primary tumor,pathological type of intracranial tumor,ki⁃67 index of intracranial metastases,location of intracranial metastases,maximum diameter,whether there is multiple occurrences,whether metastases elsewhere,coagulation function,D dimer,albumin,lactate dehydrogenase,from February 2012 to December 2021.T⁃test and chi⁃square test were used to screen for the suspected risk factors that may cause brain metastasis associated hemorrhage.Multivariate logistic regression was used to determine factors independently associated with brain metastases apoplexy.Results:Tumor hemorrhage occurred in 33 of the 264 cases of brain metastases(12.5%),of which lung cancer cerebral metastases were the most common(13/33),followed by liver cancer(6/33),and 6 of the 8 cases of hepatocellular carcinoma brain metastases had hemorrhage.Hypertension,hepatocellular carcinoma metastasis,and metastases located in the cerebral hemispheres are independent related risk factors affecting brain metastases apoplexy.Conclusion:Brain metastases apoplexy is associated with a variety of risk factors,and early identification of risk factors may help toreduce the occurrence of tumor hemorrhage and improve the prognosis of brain metastases.

关 键 词：脑转移瘤 肿瘤卒中 脑出血 肺癌 肝细胞癌 

分 类 号：R739.41[医药卫生—肿瘤]