亚洲颅内静脉血栓形成研究。

Asian Study of Cerebral Venous Thrombosis.

机构信息

Department of Medicine, Aga Khan University, Karachi, Pakistan.

Department of Neurology, Nizam Institute of Neurology, Hyderabad, India.

出版信息

J Stroke Cerebrovasc Dis. 2019 Oct;28(10):104247. doi: 10.1016/j.jstrokecerebrovasdis.2019.06.005. Epub 2019 Jul 24.

DOI:10.1016/j.jstrokecerebrovasdis.2019.06.005

PMID:31350167

Abstract

BACKGROUND/OBJECTIVE: Most of the studies and registries related to cerebral venous thrombosis (CVT) are reported from European countries and the United States. The objective of the present study is to identify risk factors, presentation, and outcome of CVT in Asian patients.

METHODS

Asian CVT registry is a prospective multinational observational study that included patients (aged > 16 years) with symptomatic CVT.

RESULTS

Eight hundred and twelve patients (59% women) from 20 centers in 9 Asian countries were included. Mean age of the patients was 31 years. Motor weakness in limbs was present in 325 (40%) patients. One hundred and eighty (22.1%) patients had a normal Glasgow coma scale (GCS) at presentation, and another 529 patients (65%) had GCS between 11 and 14. The rest (103; 13%) had a GCS of less than 10 at presentation. Permanent risk factors were present in 264 (33%) patients, transient in 342 (42%) patients, both in 43 (5%) patients and no risk factors were found in 163 (20%) patients. Anemia was present in 51%, use of oral contraceptive pills (OCP) was present in 12% women and a hypercoaguable state was present in more than 40% of those tested. One hundred and forty-three cases (18%) were in women who were either pregnant (18; 2%) or in the puerperium (up to 6 weeks postpartum; N = 125; 15%). A total of 86 (10.5%) patients were diagnosed with infection in any part of the body. The most common MRI finding was local brain edema or ischemia (53.3%) followed by hemorrhage (26.7%). Twenty-seven patients (3.3%) died during hospital stay. The mRS score at discharge was available for 661 (81%) patients. Of these, 577 (87.3%) had good functional outcome at discharge. Motor weakness at presentation, GCS of 9 or less and mental status disorder were the strongest independent predictors of mortality at last follow-up among patients with CVT.

CONCLUSIONS

Important differences were identified as compared to western data including younger age, high frequency of anemia, low use of OCP, and high frequency of hypercoaguable states. Functional outcome at discharge was good.

摘要

背景/目的：大多数与脑静脉血栓形成（CVT）相关的研究和注册都来自欧洲国家和美国。本研究的目的是确定亚洲患者 CVT 的风险因素、表现和结局。

方法

亚洲 CVT 登记处是一项前瞻性的多国观察性研究，纳入了有症状 CVT 的患者（年龄>16 岁）。

结果

来自 9 个亚洲国家 20 个中心的 812 名患者（59%为女性）纳入研究。患者的平均年龄为 31 岁。325 名（40%）患者有四肢运动无力。180 名（22.1%）患者在就诊时格拉斯哥昏迷量表（GCS）正常，另外 529 名（65%）患者 GCS 在 11-14 分之间。其余（103；13%）患者就诊时 GCS 小于 10。264 名（33%）患者有永久性危险因素，342 名（42%）患者有暂时性危险因素，43 名（5%）患者两者兼有，163 名（20%）患者无危险因素。51%的患者存在贫血，12%的女性使用口服避孕药（OCP），超过 40%的患者检测到高凝状态。143 例（18%）患者为妊娠（18 例；2%）或产褥期（产后 6 周内；N=125；15%）女性。共有 86 例（10.5%）患者在身体任何部位被诊断为感染。最常见的 MRI 表现是局部脑水肿或缺血（53.3%），其次是出血（26.7%）。27 名（3.3%）患者在住院期间死亡。661 名（81%）患者出院时可获得 mRS 评分。其中，577 名（87.3%）患者出院时功能预后良好。CVT 患者就诊时的运动无力、GCS 小于 9 分和精神状态障碍是最后随访时死亡的最强独立预测因素。