中国卒中杂志2018，Vol.13Issue(5)：437-443,7.DOI:10.3969/j.issn.1673-5765.2018.05.006
原发性脑出血超急性期血肿增长速度与临床预后的关系研究
Analysis of Association between Ultraearly Hematoma Growth and Outcome after Acute Spontaneous Intracerebral Hemorrhage
摘要
Abstract
Objective To investigate the association of ultraearly hematoma growth (UHG) with the hematoma growth (HG) and clinical outcomes in patients with acute spontaneous intracerebral hemorrhage (ICH). Methods Acute ICH patients who went for consultation within 6 hours after onset were enrolled into study consecutively. Patients underwent baseline and 24-hour computed tomography (CT) scans. The clinical data and outcome were recorded. UHG was defined as the relation between baseline ICH volume/onset-to-imaging time (OIT). Hematoma enlargement was defined as HG volume >33% or >6 ml at 24 hours after onset. And poor outcome was defined as modified Rankin Scale score >2 at 90 days and 1 year after onset. The multivariable logistic regression analysis was used to investigate the association of UHG with HG and clinical outcomes after ICH. Results A total of 148 patients with acute (<6 h) ICH were enrolled. The median speed of UHG was 5.3 (interquartile range 2.3-12.9) ml/h. The UHG was significantly faster in patients who scanned earlier (P<0.001), as well as in patients who experienced HG (P=0.019), 90-day poor outcome (P<0.001) and 1-year poor outcome (P<0.001). UHG>4.7 ml/h was an independent risk factor for 1-year poor outcome (odds ratio 17.5; 95% confidence interval 1.44-21.23, P=0.025). For UHG to predict 1-year poor outcome, the sensitivity, specificity, positive predictive value and negative predictive value were 61.5%, 65.1%, 68.4% and 58%, respectively. Conclusion UHG was an independent risk factor for 1-year poor outcome after acute ICH.关键词
脑出血/超急性期血肿增长速度/血肿扩大/预后Key words
Intracerebral hemorrhage/Ultraearly hematoma growth/Hematoma growth/Outcome引用本文复制引用
王文娟,陆菁菁,陈胜云,张佳,王玉,张晓丽,赵性泉..原发性脑出血超急性期血肿增长速度与临床预后的关系研究[J].中国卒中杂志,2018,13(5):437-443,7.基金项目
首都卫生发展科研专项项目(重点攻关)-北京地区以病因为基础的脑出血医疗质量评价与微创治疗技术的研究(首发2011-2004-03)"首都临床特色应用研究"专项-脑出血急性期一站式多模式CT应用规范的研究(Z131107002213009) （重点攻关）
