CAJ | 학술논문

目的研究探讨动脉瘤性蛛网膜下腔出血（subarachnoid hemorrhage，SAH）继发症状性脑血管痉挛（symptomatic cerebral vasospasm，SCVS）的相关危险因素，为SCVS的防治提供参考。 　　方法回顾性分析96例SAH患者临床资料，对性别、年龄、高血压史、糖尿病史、Fisher分级等影响因素进行统计学分析。 　　结果96例患者中发生SCVS的患者共39例，单因素分析结果显示SCVS组与非SCVS组在年龄、高血压、吸烟、脑室内积血、Hunt-Hess分级、Fisher分级、数字减影血管造影（digital subtraction angiography， DSA）显示血管痉挛程度、尼莫地平使用等方面差异有显著性；多因素Logistic回归分析结果显示：低龄、高血压史、Fisher分级是发生SCVS的危险因素，其比值比（odds ratio，OR）分别为0.567、1.982和2.713；而尼莫地平的使用是SCVS发生的保护因素，OR为0.799。 　　结论 SAH后SCVS是多种因素共同作用的结果，其中低年龄、高血压史、Fisher分级是SCVS的独立危险因素，尼莫地平使用为保护因素。
목적연구탐토동맥류성주망막하강출혈（subarachnoid hemorrhage，SAH）계발증상성뇌혈관경련（symptomatic cerebral vasospasm，SCVS）적상관위험인소，위SCVS적방치제공삼고。 　　방법회고성분석96례SAH환자림상자료，대성별、년령、고혈압사、당뇨병사、Fisher분급등영향인소진행통계학분석。 　　결과96례환자중발생SCVS적환자공39례，단인소분석결과현시SCVS조여비SCVS조재년령、고혈압、흡연、뇌실내적혈、Hunt-Hess분급、Fisher분급、수자감영혈관조영（digital subtraction angiography， DSA）현시혈관경련정도、니막지평사용등방면차이유현저성；다인소Logistic회귀분석결과현시：저령、고혈압사、Fisher분급시발생SCVS적위험인소，기비치비（odds ratio，OR）분별위0.567、1.982화2.713；이니막지평적사용시SCVS발생적보호인소，OR위0.799。 　　결론 SAH후SCVS시다충인소공동작용적결과，기중저년령、고혈압사、Fisher분급시SCVS적독립위험인소，니막지평사용위보호인소。
Objective To explore the risk factors for cerebral symptomatic vasospasm following subarachnoid hemorrhage (SAH), and provide reference for the prevention and treatment of symptomatic cerebral vasospasm (SCVS). Methods The clinical data of 96 SAH patients were retrospectively analyzed, and the risk factors such as gender, age, history of hypertension, history of diabetes, modified Fisher grades were statistically analyzed. Results Of all 96 patients, 39 were found SCVS. There were statistical differences in age, history of hypertension, cigarette smoking, intraventricular hemorrhage, Hunter-Hess grade, modified Fisher grades, the degree of vasospasm, and the use of nimodipine between the group of SCVS and the group of non-SCVS by univariate analysis. Logistic regression analysis demonstrates that lower age, history of hypertension, modiifed Fisher grades are the risk factors of SCVS, and the value of their ORs are 0.567, 1.982, 2.713, respectively. The use of nimodipine is the conservancy factor, and the value of its OR is 0.799. Conclusion SCVS after SAH is the result of co-action of multiple factors. The age, history of hypertension, modiifed Fisher grades, and the use of nimodipine are independent risk factors. Early detection and treatment should be strengthened.