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动脉瘤性蛛网膜下腔出血患者发生脑血管痉挛的危险因素。

Risk factors for cerebral vasospasm in patients with aneurysmal subarachnoid hemorrhage.

作者信息

Opancina Valentina, Lukic Snezana, Jankovic Slobodan, Vojinovic Radisa, Mijailovic Milan

机构信息

University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Radiology, Serbia.

University of Kragujevac, Serbia, Faculty of Medical Sciences, Department of Pharmacology and Toxicology, Serbia.

出版信息

Open Med (Wars). 2020 Jul 3;15(1):598-604. doi: 10.1515/med-2020-0169. eCollection 2020.

Abstract

INTRODUCTION

Aneurysmal subarachnoid hemorrhage is a type of spontaneous hemorrhagic stroke, which is caused by a ruptured cerebral aneurysm. Cerebral vasospasm (CVS) is the most grievous complication of subarachnoid hemorrhage (SAH). The aim of this study was to examine the risk factors that influence the onset of CVS that develops after endovascular coil embolization of a ruptured aneurysm.

MATERIALS AND METHODS

The study was designed as a cross-sectional study. The patients included in the study were 18 or more years of age, admitted within a period of 24 h of symptom onset, diagnosed and treated at a university medical center in Serbia during a 5-year period.

RESULTS

Our study showed that the maximum recorded international normalized ratio (INR) values in patients who were not receiving anticoagulant therapy and the maximum recorded white blood cells (WBCs) were strongly associated with cerebrovascular spasm, increasing its chances 4.4 and 8.4 times with an increase of each integer of the INR value and 1,000 WBCs, respectively.

CONCLUSIONS

SAH after the rupture of cerebral aneurysms creates an endocranial inflammatory state whose intensity is probably directly related to the occurrence of vasospasm and its adverse consequences.

摘要

引言

动脉瘤性蛛网膜下腔出血是一种自发性出血性中风,由脑动脉瘤破裂引起。脑血管痉挛(CVS)是蛛网膜下腔出血(SAH)最严重的并发症。本研究的目的是探讨影响破裂动脉瘤血管内弹簧圈栓塞术后发生CVS的危险因素。

材料与方法

本研究设计为横断面研究。纳入研究的患者年龄在18岁及以上,在症状发作后24小时内入院,在塞尔维亚的一家大学医学中心在5年期间进行诊断和治疗。

结果

我们的研究表明,未接受抗凝治疗患者的最高记录国际标准化比值(INR)值和最高记录白细胞(WBC)与脑血管痉挛密切相关,INR值每增加一个整数,脑血管痉挛发生几率增加4.4倍,白细胞每增加1000个,脑血管痉挛发生几率增加8.4倍。

结论

脑动脉瘤破裂后的SAH会产生一种颅内炎症状态,其强度可能与血管痉挛的发生及其不良后果直接相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6815/7712228/f43794e11796/j_med-2020-0169-fig001.jpg

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