Stroke:CT平扫低密度提示脑出血患者预后不良

2016-09-19 MedSci MedSci原创

研究背景和研究目的:通过可回收支架进行动脉内治疗已经被证实是安全和有效的。在MR CLEAN(荷兰急性缺血性卒中血管内治疗的多中心随机临床试验)中,血栓摘除装置种类的选择由术者自行决定。这项研究旨在探究支架类型和构造对功能预后,神经功能恢复,再灌注,梗死的范围及不良事件发生的影响。 研究方法:主要结局是根据改良Rankin量表(mRS)评估的90天功能结局。神经影像结局包括24小时CT血管造

研究背景和目的:CT平扫低密度表明和脑出血的血肿扩大相关,但其对功能预后的影响还不明确。因此我们评估了基线CT平扫低密度是否和差的临床预后相关。


研究方法:我们在1994到2016年单中心连续纳入首发脑出血的前瞻性队列中进行了回顾性的研究。基线CT低密度由两个独立评估者分别完成。差的预后定义为90天MRS评分大于3分。CT低密度和差的预后之间的关系通过单变量和多变量逻辑回归模型分析。 

研究结果:研究阶段,1342位病人表现脑出血,800位符合纳入标准(基线CT及90天MRS评分可用)。304位病人(38%)表现为CT低密度,520位病人(65%)预后不良。单变量分析中,不良预后病人更多表现为低密度(48% :20%; P<0.0001)。进行年龄,入院GCS评分,华法林使用,脑室内出血,基线脑出血体积及脑出血部位的调整后,发现CT低密度和不良预后风险增加相关(OR 1.70, 95%置信区间[1.10–2.65]; P=0.018)。 

结论:脑出血病人中基线CT平扫低密度独立预测差的临床预后,可以成为一个有用的,并可广泛应用增加我们预测脑出血病人临床进展能力的指标。

原始出处:

Boulouis G, Morotti A, Brouwers HB,et al, Noncontrast Computed Tomography Hypodensities Predict Poor Outcome in Intracerebral Hemorrhage Patients,Stroke. 2016 Sep 6. pii: STROKEAHA.116.014425. [Epub ahead of print]

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    学习知识

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=1691884, encodeId=88c5169188468, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Thu Oct 27 14:19:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488328, encodeId=a7b31488328f5, content=<a href='/topic/show?id=b34f1001e187' target=_blank style='color:#2F92EE;'>#预后不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100171, encryptionId=b34f1001e187, topicName=预后不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b86b8414062, createdName=caoliehu, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1518999, encodeId=9c9d151899975, content=<a href='/topic/show?id=44275455fd' target=_blank style='color:#2F92EE;'>#CT平扫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5455, encryptionId=44275455fd, topicName=CT平扫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb4811230693, createdName=shenxlcyp, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131460, encodeId=f80a1314603e, content=学习知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue Sep 20 15:52:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131173, encodeId=34541311e323, content=出血预后差,变为直接低密度面积大预后差!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzSEB4Gw5zzMTFicSXpRPB29ZqXZWCwpKGlNQClGxQkM0V13y0nwwfOibuwhkgK3VibicMKbKcMSUzTzp/0, createdBy=e5131935950, createdName=1e0dde21m68(暂无匿称), createdTime=Tue Sep 20 07:29:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131141, encodeId=7739131141bc, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Tue Sep 20 03:19:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131108, encodeId=4f75131108c9, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131109, encodeId=938613110910, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=)]
    2016-09-20 1e0dde21m68(暂无匿称)

    出血预后差,变为直接低密度面积大预后差!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1691884, encodeId=88c5169188468, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Thu Oct 27 14:19:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488328, encodeId=a7b31488328f5, content=<a href='/topic/show?id=b34f1001e187' target=_blank style='color:#2F92EE;'>#预后不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100171, encryptionId=b34f1001e187, topicName=预后不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b86b8414062, createdName=caoliehu, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1518999, encodeId=9c9d151899975, content=<a href='/topic/show?id=44275455fd' target=_blank style='color:#2F92EE;'>#CT平扫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5455, encryptionId=44275455fd, topicName=CT平扫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb4811230693, createdName=shenxlcyp, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131460, encodeId=f80a1314603e, content=学习知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue Sep 20 15:52:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131173, encodeId=34541311e323, content=出血预后差,变为直接低密度面积大预后差!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzSEB4Gw5zzMTFicSXpRPB29ZqXZWCwpKGlNQClGxQkM0V13y0nwwfOibuwhkgK3VibicMKbKcMSUzTzp/0, createdBy=e5131935950, createdName=1e0dde21m68(暂无匿称), createdTime=Tue Sep 20 07:29:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131141, encodeId=7739131141bc, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Tue Sep 20 03:19:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131108, encodeId=4f75131108c9, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131109, encodeId=938613110910, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=)]
    2016-09-20 lhl629

    很好的内容,谢谢分享。

    0

  7. [GetPortalCommentsPageByObjectIdResponse(id=1691884, encodeId=88c5169188468, content=<a href='/topic/show?id=a450530853c' target=_blank style='color:#2F92EE;'>#患者预后#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53085, encryptionId=a450530853c, topicName=患者预后)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8f4729287700, createdName=bnurmamat, createdTime=Thu Oct 27 14:19:00 CST 2016, time=2016-10-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1488328, encodeId=a7b31488328f5, content=<a href='/topic/show?id=b34f1001e187' target=_blank style='color:#2F92EE;'>#预后不良#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100171, encryptionId=b34f1001e187, topicName=预后不良)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b86b8414062, createdName=caoliehu, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1518999, encodeId=9c9d151899975, content=<a href='/topic/show?id=44275455fd' target=_blank style='color:#2F92EE;'>#CT平扫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5455, encryptionId=44275455fd, topicName=CT平扫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=bb4811230693, createdName=shenxlcyp, createdTime=Wed Sep 21 13:19:00 CST 2016, time=2016-09-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131460, encodeId=f80a1314603e, content=学习知识, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Tue Sep 20 15:52:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131173, encodeId=34541311e323, content=出血预后差,变为直接低密度面积大预后差!, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzSEB4Gw5zzMTFicSXpRPB29ZqXZWCwpKGlNQClGxQkM0V13y0nwwfOibuwhkgK3VibicMKbKcMSUzTzp/0, createdBy=e5131935950, createdName=1e0dde21m68(暂无匿称), createdTime=Tue Sep 20 07:29:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131141, encodeId=7739131141bc, content=很好的内容,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=ceb079804, createdName=lhl629, createdTime=Tue Sep 20 03:19:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131108, encodeId=4f75131108c9, content=继续学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=77, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=131109, encodeId=938613110910, content=继续关注, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzfPkmqRTH5rHib5mcib8Wb3QdXjhfOK1UubQL2lictjJFdFJ6Lc3cnnCOSWqxXZ4Kk6y5GdzDoy764R/0, createdBy=156e1644785, createdName=doctorJiangchao, createdTime=Tue Sep 20 00:08:00 CST 2016, time=2016-09-20, status=1, ipAttribution=)]
    2016-09-20 doctorJiangchao

    继续学习

    0

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    2016-09-20 doctorJiangchao

    继续关注

    0