中国神经精神疾病杂志
中國神經精神疾病雜誌
중국신경정신질병잡지
CHINESE JOURNAL OF NERVOUS AND MENTAL DISEASES
2015年
8期
455-459
,共5页
张健%师春梅%周春燕%邢世会%李踔%李晶晶%欧紫琳%陈红兵%谭双全%党超%刘刚%曾进胜
張健%師春梅%週春燕%邢世會%李踔%李晶晶%歐紫琳%陳紅兵%譚雙全%黨超%劉剛%曾進勝
장건%사춘매%주춘연%형세회%리탁%리정정%구자림%진홍병%담쌍전%당초%류강%증진성
颅内静脉系统血栓形成%脑出血%临床表现%危险因素%预后
顱內靜脈繫統血栓形成%腦齣血%臨床錶現%危險因素%預後
로내정맥계통혈전형성%뇌출혈%림상표현%위험인소%예후
Cerebral venous sinus thrombosis%Cerebral hemorrhage%Clinical characteristics%Risk factor Out-come
目的：分析颅内静脉系统血栓形成合并脑出血患者在临床表现、危险因素、治疗方法和急性期预后方面的特点。方法研究入组确诊的颅内静脉系统血栓形成的患者75例，依据头部影像学将颅内静脉系统血栓形成患者分为不合并脑出血和合并出脑血两组。比较两组患者在人口学资料、潜在危险因素、临床表现、影像学特点、治疗方法和急性期预后的差异。最后分析颅内静脉系统血栓形成合并出血的高危因素。结果研究入组75例确诊的颅内静脉系统血栓形成患者，其中28例（37.2%）合并脑出血，47例（62.7%）不合并脑出血。合并出血组妊娠和产褥期患者的比例高（28.6%vs.6.4%，P=0.015），而不合并出血组感染的比例高（29.8%vs.7.1%， P=0.021）。合并出血组患者头痛（92.9%vs.70.2%，P=0.021）、意识障碍（25.0%vs.6.4%，P=0.034）、痫性发作（53.6%vs.19.1%，P=0.002）、运动障碍（35.7%vs.12.8%，P=0.019）更常见。此外，合并出血组累及多个静脉窦的比例较不合并出血组高（71.4% vs.44.7%，P =0.024），急性期预后较不合并出血组差（mRS≥3：46.4%vs.17.0%，P=0.006）。但是，合并出血组使用抗凝药物的18例患者中有12例急性期预后良好。二分类变量Lo?gistic回归分析分析显示结果发现妊娠和产褥期（P=0.004）、多个静脉窦受累（P=0.007）与颅内静脉系统血栓形成合并出血成正相关，而感染（P=0.03）与出血成负相关。结论颅内静脉系统血栓形成合并脑出血组妊娠和产褥期患者的比例高，头痛、意识障碍、痫性发作、运动障碍、累及多个静脉窦更常见，而急性期预后更差。
目的：分析顱內靜脈繫統血栓形成閤併腦齣血患者在臨床錶現、危險因素、治療方法和急性期預後方麵的特點。方法研究入組確診的顱內靜脈繫統血栓形成的患者75例，依據頭部影像學將顱內靜脈繫統血栓形成患者分為不閤併腦齣血和閤併齣腦血兩組。比較兩組患者在人口學資料、潛在危險因素、臨床錶現、影像學特點、治療方法和急性期預後的差異。最後分析顱內靜脈繫統血栓形成閤併齣血的高危因素。結果研究入組75例確診的顱內靜脈繫統血栓形成患者，其中28例（37.2%）閤併腦齣血，47例（62.7%）不閤併腦齣血。閤併齣血組妊娠和產褥期患者的比例高（28.6%vs.6.4%，P=0.015），而不閤併齣血組感染的比例高（29.8%vs.7.1%， P=0.021）。閤併齣血組患者頭痛（92.9%vs.70.2%，P=0.021）、意識障礙（25.0%vs.6.4%，P=0.034）、癇性髮作（53.6%vs.19.1%，P=0.002）、運動障礙（35.7%vs.12.8%，P=0.019）更常見。此外，閤併齣血組纍及多箇靜脈竇的比例較不閤併齣血組高（71.4% vs.44.7%，P =0.024），急性期預後較不閤併齣血組差（mRS≥3：46.4%vs.17.0%，P=0.006）。但是，閤併齣血組使用抗凝藥物的18例患者中有12例急性期預後良好。二分類變量Lo?gistic迴歸分析分析顯示結果髮現妊娠和產褥期（P=0.004）、多箇靜脈竇受纍（P=0.007）與顱內靜脈繫統血栓形成閤併齣血成正相關，而感染（P=0.03）與齣血成負相關。結論顱內靜脈繫統血栓形成閤併腦齣血組妊娠和產褥期患者的比例高，頭痛、意識障礙、癇性髮作、運動障礙、纍及多箇靜脈竇更常見，而急性期預後更差。
목적：분석로내정맥계통혈전형성합병뇌출혈환자재림상표현、위험인소、치료방법화급성기예후방면적특점。방법연구입조학진적로내정맥계통혈전형성적환자75례，의거두부영상학장로내정맥계통혈전형성환자분위불합병뇌출혈화합병출뇌혈량조。비교량조환자재인구학자료、잠재위험인소、림상표현、영상학특점、치료방법화급성기예후적차이。최후분석로내정맥계통혈전형성합병출혈적고위인소。결과연구입조75례학진적로내정맥계통혈전형성환자，기중28례（37.2%）합병뇌출혈，47례（62.7%）불합병뇌출혈。합병출혈조임신화산욕기환자적비례고（28.6%vs.6.4%，P=0.015），이불합병출혈조감염적비례고（29.8%vs.7.1%， P=0.021）。합병출혈조환자두통（92.9%vs.70.2%，P=0.021）、의식장애（25.0%vs.6.4%，P=0.034）、간성발작（53.6%vs.19.1%，P=0.002）、운동장애（35.7%vs.12.8%，P=0.019）경상견。차외，합병출혈조루급다개정맥두적비례교불합병출혈조고（71.4% vs.44.7%，P =0.024），급성기예후교불합병출혈조차（mRS≥3：46.4%vs.17.0%，P=0.006）。단시，합병출혈조사용항응약물적18례환자중유12례급성기예후량호。이분류변량Lo?gistic회귀분석분석현시결과발현임신화산욕기（P=0.004）、다개정맥두수루（P=0.007）여로내정맥계통혈전형성합병출혈성정상관，이감염（P=0.03）여출혈성부상관。결론로내정맥계통혈전형성합병뇌출혈조임신화산욕기환자적비례고，두통、의식장애、간성발작、운동장애、루급다개정맥두경상견，이급성기예후경차。
Objective To analyze the characteristics of clinical manifestations, risk factors, therapies and acute outcomes in patients with cerebral venous sinus thrombosis complicated by cerebral hemorrhage. Methods Seventy-five patients with cerebral venous sinus thrombosis were included in the study. According to the radiological findings on the brain image, patients were divided into two subgroups:cerebral hemorrhage group and non-hemorrhage group. The demo?graphic data, potential risk factors, clinical manifestations, radiological features, therapeutic strategies and acute out?comes were compared between two subgroups, and high risk factors were also analyzed. Results There were seventy-five patients with cerebral venous sinus thrombosis in the present study. Twenty-eight patients of them (37.2%) had cerebral hemorrhage whereas the remaining forty-seven patients (62.7%) did not have cerebral hemorrhage. Pregnancy/puerperi?um were significantly higher in patients with cerebral hemorrhage (with vs without;28.6%vs. 6.4%, P=0.015), while in?fection was markedly higher in patients without cerebral hemorrhage (with vs without;7.1% vs. 29.8%, P=0.021). Head?ache (92.9% vs. 70.2%, P=0.021), unconsciousness (25.0% vs. 6.4%,P=0.034), seizures (53.6% vs. 19.1%, P=0.002) and motor deficits (35.7% vs. 12.8%, P=0.019) were more common in patients with cerebral hemorrhage. Moreover, mul?tiple sinus involvement (1.4% vs. 44.7%, P=0.024) was significantly higher and the acute outcomes(mRS≥3: 46.4%vs.17.0%, P=0.006)were poorer in patients with cerebral hemorrhage. Binary Logistic analysis showed that pregnancy/pu?erperium (P=0.004) and multiple sinus involvement were positively, whereas infection was negatively correlated with cere?bral venous sinus thrombosis and hemorrhage ( P=0.007;P=0.03). Conclusions Pregnancy/puerperium, headache, uncon?sciousness, seizures, motor deficits and multiple sinus involvement are more frequently in patients with cerebral venous sinus thrombosis and hemorrhage, and the acute outcomes are poorer in patients with cerebral venous sinus thrombosis complicated by cerebral hemorrhage.
