摘要
目的探讨脑白质疏松(leukoaraiosis,LA)对自发性幕上脑出血预后的影响。方法选择118例自发性幕上脑出血患者的临床资料,根据格拉斯哥结局量表评分,分为预后良好组58例和预后不良组60例。比较2组人口统计学资料、血肿特征以及LA的严重程度;采用van Swieten量表评价头颅CT上LA的严重程度。结果与预后良好组比较,预后不良组患者年龄、收缩压、血糖、LA评分、血肿体积、合并脑室出血明显升高(P<0.05.P<0.01),格拉斯哥昏迷评分明显降低(P<0.01)。多因素logistic逐步回归分析显示,LA评分、格拉斯哥昏迷评分、血肿体积以及合并脑室出血是预后不良的独立预测因素。结论 LA是自发性幕上脑出血患者预后不良的独立预测因素之一。
Objective To investigate the effect of leukoaraiosis（LA）on the prognosis of spontaneous supratentorial intracerebral hemorrhage. Methods 118 consecutive patients with spontaneous supratentorial intraeerebral hemorrhage were registered and their clinical data were collected. The patients were divided into two groups according to prognosis on 90th day： 58 patients had good prognosis（Glasgow Outcome Scale≥4） and 60（50.8 %） patients had poor prognosis. Demographic features,hematoma characteristics, and I.A severity assessed by van Swieten score on brain CT were compared between the two groups. Results Compared with good prognosis group, the patients with poor prognosis were older, and had higher systolic pressure, higher serum glucose level on admission,higher LA scores,larger hematoma volume,and more frequent hematoma extension to the ventricle（P〈0.05,P〈0.01）. Initial Glasgow Coma Scale（GCS）scores were lower in those with poor prognosis（P〈0.01）. The multi-factor logistic regression analysis showed that severity of LA（OR=5. 390,95 % CI： 1. 417--20. 503,P〈0.01）,initial GCS score（OR = 23. 730,95%CI： 4. 923-114. 371, P〈0.01）,hematoma volume（OR= 1. 202,95%CI. 1. 079-- 1. 338, P〈0.01）, and presence of intraventricular hemorrhage （OR： 6.079,95 % CI ： 1.035 -- 35.712, P〈0.05 ） were independent predictors of poor prognosis. Conclusion LA is one of the independent predictors of poor prognosis in patients with spontaneous supratentorial intracerebral hemorrhage.
出处
《中华老年心脑血管病杂志》
CAS
北大核心
2012年第1期8-10,共3页
Chinese Journal of Geriatric Heart,Brain and Vessel Diseases
