Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, 6 Tiantan Xili, Chongwen District, 100050, Beijing, China.
Neurosurg Rev. 2013 Oct;36(4):533-9. doi: 10.1007/s10143-013-0474-x. Epub 2013 Jun 14.
Despite being widely accepted as an important cause of spontaneous intracranial hemorrhage (ICH), cerebral amyloid angiopathy (CAA) has seldom been studied in the Chinese population. The current study aims to investigate the incidence and features of CAA in surgically treated ICH patients in China. From May 2006 to April 2011, 974 patients admitted to 71 hospitals throughout China for acute spontaneous ICH were studied. Craniotomy for hematoma evacuation was performed. Brain tissue from the superficial side of the suspected residual hematoma cavity, as well as from the cortex and subcortex, was obtained. Congo Red stain and β-amyloid immunohistochemistry were used for the diagnosis. Each case was assigned a pathological severity score. Of the 974 involved patients, 37.7% were identified with CAA of different degrees. CAA had positive correlation with age and was independent of sex. Most patients had mild CAA with only the superficial vessels involved in lobes instead of the basal ganglia; the patients ≥65 years had more severe pathological score of CAA than those <65 years and had more lobes and cerebellum involved than the latter. More than one third of the surgically treated Chinese ICH patients may have CAA of different degrees.
尽管脑淀粉样血管病（Cerebral Amyloid Angiopathy，CAA）被广泛认为是自发性颅内出血（Spontaneous Intracranial Hemorrhage，ICH）的重要病因之一，但在中国人中对其进行的研究却很少。本研究旨在探讨中国手术治疗 ICH 患者中 CAA 的发生率和特征。2006 年 5 月至 2011 年 4 月，研究纳入了中国 71 家医院的 974 例因急性自发性 ICH 入院的患者。对这些患者进行开颅血肿清除术，获取疑似残余血肿腔表面、皮质和皮质下的脑组织。使用刚果红染色和β-淀粉样蛋白免疫组化进行诊断。对每个病例进行病理严重程度评分。在纳入的 974 例患者中，37.7%存在不同程度的 CAA。CAA 与年龄呈正相关，与性别无关。大多数患者为轻度 CAA，仅累及脑叶的浅层血管而不累及基底节；年龄≥65 岁的患者 CAA 病理评分比年龄<65 岁的患者更严重，且累及的脑叶和小脑更多。超过三分之一的中国手术治疗 ICH 患者可能存在不同程度的 CAA。
