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脑小血管病患者合并脑出血的临床特征及相关因素:一项横断面研究。

Clinical features and associated factors of coexisting intracerebral hemorrhage in patients with cerebral small vessel disease: a cross-sectional study.

机构信息

Department of Neurology, The First Affiliated Hospital of Zhengzhou University, No. 1 Eastern Jianshe Road, Erqi District, Zhengzhou, 450052, Henan Province, China.

出版信息

Sci Rep. 2024 Mar 7;14(1):5596. doi: 10.1038/s41598-024-55968-9.

Abstract

Intracerebral hemorrhage (ICH) is generally considered to be closely related to cerebral small vessel disease (CSVD), leading to a poor prognosis. However, the coexistence of ICH in general CSVD patients and related factors remain underreported. In our cross-sectional study, we screened 414 CSVD patients from a database at the Department of Neurology, First Affiliated Hospital of Zhengzhou University (September 2018 to April 2022). Imaging biomarkers of CSVD and coexisting ICH lesion were assessed. Factors associated with coexisting ICH in CSVD were determined using multivariate logistic regression analysis. ICH was observed in 59 patients (14.3%). Multivariate logistic regression showed that previous history of ischemic stroke or transient ischemic attack (OR 5.189, 95%CI 2.572-10.467, P < 0.001), high-grade perivascular space in the basal ganglia (n > 10) (OR 2.051, 95%CI 1.044-4.027, P = 0.037) and low adjusted calcium-phosphorus product (OR 0.728 per 1 [mmol/L] increase, 95%CI 0.531-0.998, P = 0.049) were associated with coexisting ICH in CSVD patients. The considerable proportion of coexisting ICH and revelation of associated factors in general CSVD patients alert physicians of the potential risk of the reoccurrence of ICH, and might have a significant impact on therapeutic strategies.

摘要

脑出血(ICH)通常被认为与脑小血管疾病(CSVD)密切相关,导致预后不良。然而,ICH 在一般 CSVD 患者中的共存及其相关因素仍报道较少。在我们的横断面研究中,我们从郑州大学第一附属医院神经内科的数据库中筛选了 414 例 CSVD 患者(2018 年 9 月至 2022 年 4 月)。评估 CSVD 的影像生物标志物和共存 ICH 病变。使用多变量逻辑回归分析确定与 CSVD 中并存 ICH 相关的因素。在 59 例患者(14.3%)中观察到 ICH。多变量逻辑回归显示,缺血性卒中和短暂性脑缺血发作的既往史(OR 5.189,95%CI 2.572-10.467,P<0.001)、基底节高分级血管周围间隙(n>10)(OR 2.051,95%CI 1.044-4.027,P=0.037)和调整后的钙磷乘积降低(OR 每增加 1 [mmol/L] 为 0.728,95%CI 0.531-0.998,P=0.049)与 CSVD 患者中并存的 ICH 相关。一般 CSVD 患者中并存 ICH 的比例相当大,以及相关因素的揭示,提醒医生ICH 再发的潜在风险,可能对治疗策略产生重大影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ef10/10920749/fe3549671e71/41598_2024_55968_Fig1_HTML.jpg

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