Wang Zi-Jie, Zhao Rui, Hu Xiao, Yang Wen-Song, Deng Lan, Lv Xin-Ni, Li Zuo-Qiao, Cheng Jing, Pu Ming-Jun, Tang Zhou-Ping, Wu Guo-Feng, Zhao Li-Bo, Xie Peng, Li Qi
Department of Neurology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Neurology, Yongchuan Hospital of Chongqing Medical University, Chongqing, China.
Front Neurosci. 2022 May 12;16:888198. doi: 10.3389/fnins.2022.888198. eCollection 2022.
To investigate the association between cerebral small vessel disease (SVD) and hematoma volume in primary intracerebral hemorrhage (ICH).
Patients from a prospective ICH cohort were enrolled. Admission and follow-up CT scan within 72 h after onset were reviewed to calculate the final hematoma volume. We evaluated cortical superficial siderosis and the global SVD score, including white matter hyperintensities, lacunes, enlarged perivascular space, and cerebral microbleeds on MRI. We conducted the multivariate logistic regression analyses to explore the association between SVD markers and small ICH, as well as hematoma volume. Hematoma location was stratified into lobar and non-lobar for subgroup analysis.
A total of 187 patients with primary ICH (mean age 62.4 ± 13.4 years, 67.9% male) were enrolled. 94 (50.2%) patients had small ICH. The multivariate logistic regression analysis showed an association between global SVD score and small ICH [adjusted odds ratio (aOR) 1.27, 95% CI 1.03-1.57, = 0.027] and a trend of higher global SVD score towards non-lobar small ICH (aOR 1.23, 95% CI 0.95-1.58, = 0.122). In the multivariate linear regression analysis, global SVD score was inversely related to hematoma volume of all ICH (β = -0.084, 95% CI -0.142 to -0.025, = 0.005) and non-lobar ICH (β = -0.112, 95% CI -0.186 to -0.037, = 0.004). Lacune (β = -0.245, 95% CI -0.487 to -0.004, = 0.046) was associated with lower non-lobar ICH volume.
Global SVD score is associated with small ICH and inversely correlated with hematoma volume. This finding predominantly exists in non-lobar ICH.
探讨脑小血管病（SVD）与原发性脑出血（ICH）血肿体积之间的关联。
纳入前瞻性脑出血队列研究中的患者。回顾发病后72小时内的入院及随访CT扫描结果，以计算最终血肿体积。我们通过MRI评估皮质表面铁沉积和整体SVD评分，包括白质高信号、腔隙、血管周围间隙增宽和脑微出血。我们进行多因素逻辑回归分析，以探究SVD标志物与小脑出血以及血肿体积之间的关联。将血肿位置分为叶性和非叶性进行亚组分析。
共纳入187例原发性脑出血患者（平均年龄62.4±13.4岁，男性占67.9%）。94例（50.2%）患者为小脑出血。多因素逻辑回归分析显示，整体SVD评分与小脑出血相关[校正比值比（aOR）1.27，95%置信区间（CI）1.03 - 1.57，P = 0.027]，且整体SVD评分越高，非叶性小脑出血的趋势越明显（aOR 1.23，95% CI 0.95 - 1.58，P = 0.122）。在多因素线性回归分析中，整体SVD评分与所有脑出血的血肿体积呈负相关（β = -0.084，95% CI -0.142至 -0.025，P = 0.005），与非叶性脑出血的血肿体积也呈负相关（β = -0.112，95% CI -0.186至 -0.037，P = 0.004）。腔隙（β = -0.245，95% CI -0.487至 -0.004，P = 0.046）与非叶性脑出血体积降低相关。
整体SVD评分与小脑出血相关，且与血肿体积呈负相关。这一发现主要存在于非叶性脑出血中。
