Department of Neurosurgery, The General Hospital of Western Theater Command, Chengdu, China.
Department of Oncology, The General Hospital of Western Theater Command, Chengdu, China.
Brain Behav. 2023 Jun;13(6):e2998. doi: 10.1002/brb3.2998. Epub 2023 Apr 24.
Cerebral venous sinus thrombosis (CVST) is believed to be associated with high-altitude exposure and has worse clinical prognosis in plateau areas than in plain areas, although this needs to be further verified. This retrospective study aims to compare the clinical differences of patients with CVST in plateau and plain areas and further ascertain the role of high-altitude exposure in the etiology of aggravating predisposition toward CVST.
Twenty-four symptomatic CVST patients occurring at plateau areas (altitude ≥ 4000 m), in corresponding with 24 CVST patients occurring at plain areas (altitude ≤ 1000 m), were recruited according to the inclusion and exclusion criteria from June 2020 to December 2021. The collected data and compared parameters include clinical features, neuroimaging findings, hematology profile, lipid profile, and coagulation profile within 24 h of hospital admission, as well as the treatment method and final outcome.
There were no obvious differences of demographic characteristics, including gender, age, height, and weight between patients with CVST in plateau and plain areas, as well as medical history, neuroimaging findings, treatment protocols, and clinical outcome (all p > .05). Compared to patients with CVST at plain areas, time before hospital admission was longer and heartbeat was slower in patients with CVST at plateau areas (all p < .05). More importantly, elevated red blood cells counts, hemoglobin level, and altered coagulation function were found in patients with CVST at plateau areas (all p < .05).
CVST patients in plateau areas presented with altered clinical characteristics, altered coagulation function, and aggravated predisposition toward venous thromboembolism compared with CVST patients in plain areas. Future prospective studies will be needed to further elucidate the influences of a high altitude on the pathogenesis of CVST.
据信,脑静脉窦血栓形成(CVST)与高原暴露有关,在高原地区的临床预后比平原地区差,尽管这需要进一步验证。本回顾性研究旨在比较高原和平原地区 CVST 患者的临床差异,并进一步确定高原暴露在 CVST 发病机制中的加重易患因素中的作用。
根据纳入和排除标准,从 2020 年 6 月至 2021 年 12 月,共招募了 24 例高原地区(海拔≥4000m)出现症状性 CVST 患者和 24 例平原地区(海拔≤1000m)出现 CVST 患者。收集的资料和比较参数包括入院 24 小时内的临床特征、神经影像学发现、血液学特征、血脂谱和凝血谱,以及治疗方法和最终结局。
高原和平原地区 CVST 患者的性别、年龄、身高和体重等人口统计学特征、既往史、神经影像学发现、治疗方案和临床结局均无明显差异(均 P>.05)。与平原地区 CVST 患者相比,高原地区 CVST 患者的入院前时间较长,心率较慢(均 P<.05)。更重要的是,高原地区 CVST 患者的红细胞计数、血红蛋白水平和凝血功能改变升高(均 P<.05)。
与平原地区 CVST 患者相比,高原地区 CVST 患者的临床特征、凝血功能改变和静脉血栓栓塞易患性加重。需要进一步的前瞻性研究来阐明高原对 CVST 发病机制的影响。