Eide Per Kristian, Pripp Are Hugo
Department of Neurosurgery, Oslo University Hospital-Rikshospitalet, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway.
Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.
Clin Neurol Neurosurg. 2016 Oct;149:33-8. doi: 10.1016/j.clineuro.2016.07.024. Epub 2016 Jul 18.
Hydrocephalus (HC) caused by blockade of ventricular cerebrospinal fluid (CSF) pathways is denoted non-communicating HC. One issue not previously addressed is how the prevalence of cardiovascular disease compares between patients with non-communicating HC and the general population.
We examined whether the prevalence of cardiovascular disease (arterial hypertension, angina pectoris, cardiac infarction, and diabetes) differed between cases with non-communicating HC and a general control population, represented by participants of the North-Trøndelag Health 3 Survey (The HUNT3 Survey). A second control group consisted of patients with communicating hydrocephalus (idiopathic normal pressure hydrocephalus, iNPH).
The study included 50 cases with non-communicating HC (53.4+10.5years), and two control cohorts: 35,413 participants of the HUNT3 Survey (52.8+9.6years), and 176 iNPH patients (61.2+8.3years). All individuals were aged 35-70 years. Among the non-communicating HC patients, the results showed increased prevalence for arterial hypertension (males), cardiac infarction (females), and diabetes (females), as compared with the HUNT3 control group with significant odds ratio estimates. However, the prevalence of cardiovascular disease did not significantly differ between patients with non-communicating HC or iNPH. In patients with either non-communicating HC or iNPH and elevated pulsatile intracranial pressure (ICP) during overnight monitoring, the prevalence of diabetes was increased.
This study showed significantly increased prevalence of cardiovascular disease in non-communicating HC, indicating an association between cardiovascular disease and the development of non-communicating HC. Further, diabetes was associated with abnormal pulsatile ICP in both non-communicating HC and iNPH patients.
由脑室脑脊液(CSF)通路阻塞引起的脑积水(HC)被称为非交通性脑积水。一个此前未被探讨的问题是,非交通性脑积水患者与普通人群相比,心血管疾病的患病率情况如何。
我们研究了非交通性脑积水患者与以北特伦德拉格健康3调查(HUNT3调查)参与者为代表的普通对照人群之间,心血管疾病(动脉高血压、心绞痛、心肌梗死和糖尿病)的患病率是否存在差异。第二个对照组由交通性脑积水患者(特发性正常压力脑积水,iNPH)组成。
该研究纳入了50例非交通性脑积水患者(53.4±10.5岁),以及两个对照队列:HUNT3调查的35413名参与者(52.8±9.6岁)和176例iNPH患者(61.2±8.3岁)。所有个体年龄在35至70岁之间。在非交通性脑积水患者中,结果显示,与HUNT3对照组相比,动脉高血压(男性)、心肌梗死(女性)和糖尿病(女性)的患病率有所增加,优势比估计值具有统计学意义。然而,非交通性脑积水患者与iNPH患者之间心血管疾病的患病率没有显著差异。在非交通性脑积水或iNPH患者中,且夜间监测期间搏动性颅内压(ICP)升高的患者中,糖尿病的患病率增加。
本研究表明非交通性脑积水中心血管疾病的患病率显著增加,提示心血管疾病与非交通性脑积水的发生之间存在关联。此外,糖尿病与非交通性脑积水和iNPH患者的搏动性ICP异常有关。