Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
Department of Neurology, Beijing Shijitan hospital, Capital Medical University, Beijing, China.
CNS Neurosci Ther. 2023 May;29(5):1222-1228. doi: 10.1111/cns.14098. Epub 2023 Feb 5.
The significance of the correlation of computed tomography (CT)-based cerebral small vessel disease (SVD) markers with the clinical outcomes in patients with cerebral amyloid angiopathy (CAA)-related intracerebral hemorrhage (ICH) remains uncertain. Thus, this study aimed to explore the relationship between SVD markers and short-term outcomes of CAA-ICH.
A total of 183 patients with CAA-ICH admitted to the Xuanwu Hospital, and Beijing Fengtai You'anmen Hospital, from 2014 to 2021 were included. The multivariate logistic regression analysis was performed to identify the correlation between SVD markers based on CT and clinical outcomes at 7-day and 90-day.
Of the 183 included patients, 66 (36%) were identified with severe SVD burden. The multivariate analysis showed that the total SVD burden, white matter lesion (WML) grade, and brain atrophy indicator were independent risk factors for unfavorable outcomes at 90-day. The brain atrophy indicator was independently associated with mortality at 90-day. Severe cortical atrophy was significantly associated with early neurological deterioration.
The neuroimaging profiles of SVD based on CT in patients with CAA-ICH might predict the short-term outcome more effectively. Further studies are required to validate these findings and identify modifiable factors for preventing CAA-ICH development.
基于计算机断层扫描（CT）的脑小血管疾病（SVD）标志物与脑淀粉样血管病（CAA）相关脑出血（ICH）患者临床结局的相关性意义尚不确定。因此，本研究旨在探讨 SVD 标志物与 CAA-ICH 短期结局之间的关系。
共纳入 2014 年至 2021 年期间来自宣武医院和北京丰台右安门医院的 183 例 CAA-ICH 患者。采用多变量逻辑回归分析确定基于 CT 的 SVD 标志物与 7 天和 90 天临床结局之间的相关性。
在纳入的 183 例患者中，66 例（36%）被确定为严重 SVD 负担。多变量分析表明，总 SVD 负担、脑白质病变（WML）分级和脑萎缩指标是 90 天不良结局的独立危险因素。脑萎缩指标与 90 天死亡率独立相关。严重皮质萎缩与早期神经功能恶化显著相关。
CAA-ICH 患者基于 CT 的 SVD 神经影像学特征可能更有效地预测短期结局。需要进一步的研究来验证这些发现，并确定可改变的因素以预防 CAA-ICH 的发生。
