Neurology:脑出血周围水肿峰值与功能预后相关!

2018-02-19 xing.T MedSci原创

由此可见,峰值PHE体积是ICH后功能预后的独立预测因子。炎症过程和血肿扩张似乎与PHE的演变有关,可能是重要的治疗靶点。

近日,神经病学领域权威取杂志Neurology上发表了一篇研究文章,研究人员旨在评估脑出血患者(ICH)出血周围水肿(PHE)演化和最大水肿程度与90天功能结局之间的相关性,并明确影响水肿演变的病理生理因素。

这项回顾性队列研究纳入了2006年1月和2014年1月期间发生的自发性幕上ICH患者。研究人员使用经过验证的半自动容量算法分析了ICH和PHE的体积,采用调整了计算年龄、ICH体积和出血位置的多变量logistic回归和倾向评分匹配(PSM)评估与功能结果和PHE演变相关的指标。90天临床结局是采用改良Rankin量表得分来评估(0-3=有利结局,4-6=不利结局)。

该研究共纳入了292例患者。年龄中位数为70岁(四分位距[IQR]为62-78),平均出血量为17.7ml(IQR为7.9-40.2)。除了功能预后的已知因素,即ICH体积和位置、年龄、脑室内出血和NIH卒中量表评分,多变量logistic回归显示峰值PHE体积(比值比(OR)为0.984,95%可信区间(CI)为0.973-0.994)作为第90天结局的独立预测因子。峰值PHE体积与初始PHE增加到第3天(OR为1.060[95%CI为1.018-1.103])和第6天的中性粒细胞淋巴细胞比率(OR为1.236,95%CI为1.034-1.477;PSM队列,n=124)独立相关。最初的PHE体积增加(PSM队列,n=224)与血肿扩张(OR为3.647[95%CI为1.533-8.679])和第2-3天的发热负担(OR为1.456,95%CI为1.103-1.920)独立相关。

由此可见,峰值PHE体积是ICH后功能预后的独立预测因子。炎症过程和血肿扩张似乎与PHE的演变有关,可能是重要的治疗靶点。

原始出处:

Bastian Volbers,et al. Peak perihemorrhagic edema correlates with functional outcome in intracerebral hemorrhage.Neurology. 2018. https://doi.org/10.1212/WNL.0000000000005167

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    2019-01-22 yinhl1978
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    2018-02-21 小华子
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    2018-02-20 清风拂面

    谢谢分享学习

    0

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    2018-02-20 1ddf0692m34(暂无匿称)

    学习了.谢谢分享

    0

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    2018-02-19 1e1b8538m79(暂无匿称)

    不错的文章值得拥有

    0

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    2018-02-19 虈亣靌

    签到学习了--

    0

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