左心室肥厚和舒张功能障碍对脑出血患者预后的影响。
The Impact of Left Ventricular Hypertrophy and Diastolic Dysfunction on Outcome in Intracerebral Hemorrhage Patients.
作者信息
Albright Karen C, Burak Joshua M, Chang Tiffany R, Aysenne Aimee, Siegler James E, Schluter Laurie, Martini Sharyl R, Boehme Amelia K, Martin-Schild Sheryl
机构信息
Health Services and Outcomes Research Center for Outcome and Effectiveness Research and Education (COERE), University of Alabama at Birmingham, Birmingham, AL 35294-4410, USA ; Center of Excellence in Comparative Effectiveness Research for Eliminating Disparities (CERED) Minority Health & Health Disparities Research Center (MHRC), University of Alabama at Birmingham, Birmingham, AL 35294-4410, USA ; School of Public Health, Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL 35294-0022, USA.
Department of Medicine, Cardiology Section, Tulane University School of Medicine, New Orleans, LA 70112, USA.
出版信息
ISRN Stroke. 2013;2013. doi: 10.1155/2013/898163.
BACKGROUND
The objective of this study was to determine the prevalence of LVH and DD in patients presenting with supratentorial deep ICH and to determine if the presence of LVH or DD was an independent predictor of initial ICH volume, hematoma expansion, or poor outcome.
METHODS
A cross-sectional study was performed on ICH patients who presented from 7/2008 to 12/2010. Cases were excluded if ICH was traumatic, lobar, infratentorial, secondary to elevated international normalized ratio, suspicious for underlying structural malformation, or where surgical evacuation was performed. Logistic and linear regressions were used to assess the ability of LVH to predict ICH imaging characteristics and patient outcomes.
RESULTS
After adjusting for use of hemostatic agents, LVH was not a significant independent predictor of initial ICH volume ( = 0.344) or 33% volume expansion ( = 0.378). After adjusting for age, infectious complications, and use of hemostatic agents, LVH was not a significant independent predictor of poor functional outcome ( = 0.778). Similar results were seen for DD.
CONCLUSION
In our sample, patients with deep ICH and LVH were more likely to develop IVH, but LVH was not a significant independent predictor of initial ICH volume, hematoma expansion, or poor short-term outcome.
背景
本研究的目的是确定幕上深部脑出血患者左心室肥厚（LVH）和舒张功能障碍（DD）的患病率，并确定LVH或DD的存在是否是初始脑出血体积、血肿扩大或不良预后的独立预测因素。
方法
对2008年7月至2010年12月就诊的脑出血患者进行了一项横断面研究。如果脑出血是外伤性、脑叶性、幕下性、继发于国际标准化比值升高、怀疑存在潜在结构畸形或进行了手术清除，则排除这些病例。采用逻辑回归和线性回归来评估LVH预测脑出血影像学特征和患者预后的能力。
结果
在调整止血药物的使用后，LVH不是初始脑出血体积（P = 0.344）或33%体积扩大（P = 0.378）的显著独立预测因素。在调整年龄、感染并发症和止血药物的使用后，LVH不是功能不良预后（P = 0.778）的显著独立预测因素。DD的结果相似。
结论
在我们的样本中，深部脑出血和LVH患者更有可能发生脑室内出血，但LVH不是初始脑出血体积、血肿扩大或短期不良预后的显著独立预测因素。
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