CAJ | 학술논문

目的了解四川地区脑室内出血(IVH)的影响因素、病因、危险因素等,为IVH的临床研究提供依据.方法采用前瞻性队列研究,以四川省3家三甲医院的住院患者为基础,进行多中心协作登记,收集包括人口学因素、IVH的危险因素、临床表现、辅助检查结果等数据.结果纳入IVH患者660例,男416例(63.0％),女244例(37.0％)；年龄17 ～ 93岁,平均(60.4±13.8)岁；原发性脑室内出血(PIVH)中高血压病31例(31.3％)、动脉瘤13例(13.1％)、血管畸形18例(18.2％)、烟雾病24例(24.2％)和未知病因13例(13.1％)；而继发性脑室内出血(SIVH)中高血压病为391例(69.7％)、未知病因162例(28.9％)、动脉瘤、血管畸形和脑淀粉样血管病分别有3例(0.5％)、3例(0.5％)和2例(0.4％)；入院时PIVH和SIVH组间GCS评分差异有统计学意义,P＜0.05；PIVH组47例(47.5％)手术治疗、32例(32.3)保守治疗,18例(18.2％)伽马刀治疗,另有2例(2.0％)介入治疗；SIVH组手术、保守和介入治疗分别是175例(31.2％)、383例(68.3％)和3例(0.5％),手术、保守和伽马刀治疗组间差异有统计学意义,P ＜0.05；多因素Logistic回归分析提示年龄、高血压是发生SIVH的独立危险因素.结论本研究在国内外同类研究中样本量最大,研究质量较高,结论可靠,为IVH的临床研究设计提供了理论依据.
목적 료해사천지구뇌실내출혈(IVH)적영향인소、병인、위험인소등,위IVH적림상연구제공의거.방법 채용전첨성대렬연구,이사천성3가삼갑의원적주원환자위기출,진행다중심협작등기,수집포괄인구학인소、IVH적위험인소、림상표현、보조검사결과등수거.결과 납입IVH환자660례,남416례(63.0％),녀244례(37.0％)；년령17 ～ 93세,평균(60.4±13.8)세；원발성뇌실내출혈(PIVH)중고혈압병31례(31.3％)、동맥류13례(13.1％)、혈관기형18례(18.2％)、연무병24례(24.2％)화미지병인13례(13.1％)；이계발성뇌실내출혈(SIVH)중고혈압병위391례(69.7％)、미지병인162례(28.9％)、동맥류、혈관기형화뇌정분양혈관병분별유3례(0.5％)、3례(0.5％)화2례(0.4％)；입원시PIVH화SIVH조간GCS평분차이유통계학의의,P＜0.05；PIVH조47례(47.5％)수술치료、32례(32.3)보수치료,18례(18.2％)가마도치료,령유2례(2.0％)개입치료；SIVH조수술、보수화개입치료분별시175례(31.2％)、383례(68.3％)화3례(0.5％),수술、보수화가마도치료조간차이유통계학의의,P ＜0.05；다인소Logistic회귀분석제시년령、고혈압시발생SIVH적독립위험인소.결론 본연구재국내외동류연구중양본량최대,연구질량교고,결론가고,위IVH적림상연구설계제공료이론의거.
Objective To fully understand influencial factors,etiology and risk factors of IVH in Sichuan province for providing evidence and establishing foundation for the future clinical research on measures of prevention and cure of IVH.Methods This study included patients from 3 Third grade hospitals of Sichuan province based on collaborative multi-center registration of stroke patients.Data collection in IVH patients,including demographic factors,risk factors,clinical manifestations,and auxillary examination reports.Data were inserted,managed and statistically treated and analysed using PASW For Windows 18.0 software pakage.Results Altogether 660 hospitalized IVH patients fulfilling the inclusion criteria were consequetively registered in the three study centre.Among them,416 cases (63.0％) were male and 224 cases (37.0％) were female.Age ranged from 17 to 93 years with a mean age of 60.4 ± 13.8years.Causes of PIVH included hypertension in 31 patients (31.3％),aneurysm in 13 cases (13.1％),vascular malformations in 18 cases (18.2％),moyamoya disease in 24 patients (24.2％) and idiopathic in 13 cases (13.1％).While causes of SIVH included hypertension in 391 patients (69.7％),idiopathic in 162 patients (28.9％),aneurysms in 3 cases (0.5％),vascular malformations in 3 cases (0.5％) and cerebral amyloid angiopathy 2 cases (0.4％).There was significant difference in GCS score distribution during admission between PIVH and SIVH,P ＜ 0.05.IVH scores between groups was not statistically different.In PIVH:47 cases (47.5％) underwent surgery,32 cases (32.3％) had conservative management,18 cases (18.2％) had GKS and 2 cases (2.0％) had endovascular intervention.While in SIVH:175 cases (31.2％) underwent surgery,383 cases (68.3％) had conservative management and 3 cases(0.5％) had endovascular intervention.There was statistical significance between groups having surgical,conservative and GKS management,P ＜ 0.05.Multivariate logistic regression analysis showed age and hypertension were independent risk factors for SIVH.Conclusions Among the similar study of IVH in China or abroad,this prospective research had the largest sample size.It was the first consecutive observational study of high research quality and reliable conclusion.This study provided evidence and established foundation for the future clinical research on measures of prevention and cure of IVH.