Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Neuropsychiatric Epidemiology Research Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Mölndal, Sweden; Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden; Department of Clinical Neuroscience, Hydrocephalus Research Unit, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden.
Alzheimers Dement. 2017 Aug;13(8):850-857. doi: 10.1016/j.jalz.2017.01.013. Epub 2017 Feb 24.
We examined mortality, dementia, and progression of hydrocephalic symptoms among untreated individuals with idiopathic normal-pressure hydrocephalus (iNPH) in a population-based sample.
A total of 1235 persons were examined between 1986 and 2012. Shunted individuals were excluded. We examined 53 persons with hydrocephalic ventricular enlargement (probable iNPH: n = 24, asymptomatic or possible iNPH: n = 29). Comparisons were made with individuals without hydrocephalic ventricular enlargement.
The 5-year mortality was 87.5% among those with probable iNPH. The hazard ratio (HR) for death was 3.8 (95% confidence interval [CI]: 2.5-6.0) for probable iNPH. Those with possible iNPH and asymptomatic hydrocephalic ventricular enlargement had increased risk of developing dementia, HR 2.8 (95% CI: 1.5-5.2). Only two individuals with hydrocephalic ventricular enlargement remained asymptomatic.
In the present sample, persons with clinical and imaging signs of iNPH had excess mortality and an increased risk of dementia. The data also suggest that radiological signs of iNPH might be more important than previously supposed.
我们在一个基于人群的样本中研究了未经治疗的特发性正常压力脑积水（iNPH）患者的死亡率、痴呆和脑积水症状进展情况。
共有 1235 人在 1986 年至 2012 年期间接受了检查。排除了分流的患者。我们检查了 53 名有脑积水脑室扩大的患者（可能的 iNPH：n=24，无症状或可能的 iNPH：n=29）。并将其与无脑积水脑室扩大的患者进行了比较。
在可能的 iNPH 患者中，5 年死亡率为 87.5%。死亡的风险比（HR）为 3.8（95%置信区间[CI]：2.5-6.0）。可能的 iNPH 和无症状脑积水脑室扩大患者患痴呆的风险增加，HR 为 2.8（95% CI：1.5-5.2）。仅有 2 名有脑积水脑室扩大的患者仍无症状。
在本样本中，具有 iNPH 的临床和影像学特征的患者死亡率增加，痴呆风险增加。这些数据还表明，iNPH 的影像学征象可能比以前认为的更为重要。
