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[脑静脉窦血栓形成的临床特征及治疗变化:北京协和医院35例住院患者分析]

[Changes in clinical characteristics and treatment of cerebral venous and sinus thrombosis: analysis of 35 patients admitted in Peking Union Medical College Hospital].

作者信息

Qi Xin, Cui Li-Ying, Wang Jian-Ming

机构信息

Department of Neurology, Peking Union Medical College Hospital, Peking Union Medical College and China Academy of Medical Sciences, Beijing 100730, China.

出版信息

Zhonghua Yi Xue Za Zhi. 2008 Jun 17;88(23):1624-6.

Abstract

OBJECTIVE

To investigate the differences in etiology, symptoms, treatment, and prognosis between the patients with cerebral venous and sinus thrombosis (CVST) before December 31 2000 and those after that date.

METHODS

The etiology, symptom, treatment, and prognosis of the 35 CVST patients admitted to Peking Union Medical College Hospital (PUMC) from January 1 1991 to December 31 2000 (Group A, n = 16) and those admitted from January 1 2000 to May 31 2007 (Group B, n = 19) were analyzed and compared.

RESULTS

(1) The first two common causes were infection and hematological disease in Group A, while the first two common causes were immune disease and hematological disease in Group B. (2) The common symptoms and signs and positive rates were as follows: headache (86%), seizures (34%), focal neurological deficits (40%), vision deficits (43%), altered consciousness (31%), and papilloedema (60%) without significant differences between these 2 groups. The positive rates of the common symptoms and signs during discharge were as follows: headache (77%), altered consciousness (73%), seizures (67%), focal neurological deficits (57%), vision deficits (43%), and altered consciousness (31%) without significant differences between these 2 groups. (3) 38% of the patients in Group A (n = 6) received anticoagulation therapy, a rate significantly lower than that of Group B (79% , n = 19) (P < 0.05). Four patients in Group B received thrombolytic therapy.

CONCLUSION

The etiological constituents of CVST patients admitted in PUMC has changed, the weight of infection has declined and that of the immune disease has risen. The spectrum of signs remains unchanged; however, the rate of anticoagulation has ascended.

摘要

目的

探讨2000年12月31日前与2000年12月31日后收治的脑静脉窦血栓形成(CVST)患者在病因、症状、治疗及预后方面的差异。

方法

分析并比较1991年1月1日至2000年12月31日在北京协和医院收治的35例CVST患者(A组,n = 16)以及2000年1月1日至2007年5月31日收治的患者(B组,n = 19)的病因、症状、治疗及预后情况。

结果

(1)A组前两位常见病因是感染和血液系统疾病,而B组前两位常见病因是免疫性疾病和血液系统疾病。(2)常见症状、体征及阳性率如下:头痛(86%)、癫痫发作(34%)、局灶性神经功能缺损(40%)、视力缺损(43%)、意识改变(31%)和视乳头水肿(60%),两组间无显著差异。出院时常见症状、体征的阳性率如下:头痛(77%)、意识改变(73%)、癫痫发作(67%)、局灶性神经功能缺损(57%)、视力缺损(43%)和意识改变(31%),两组间无显著差异。(3)A组38%的患者(n = 6)接受了抗凝治疗,该比例显著低于B组(79%,n = 19)(P < 0.05)。B组有4例患者接受了溶栓治疗。

结论

北京协和医院收治的CVST患者病因构成发生了变化,感染所占比重下降,免疫性疾病比重上升。体征谱未变;然而,抗凝治疗率有所上升。

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