Stroke:蛛网膜下腔出血后骨质疏松症与脑积水的关系

2018-07-16 国际循环编辑部 国际循环

蛛网膜下腔出血(SAH)后蛛网膜颗粒的病理性阻塞可阻碍脑脊液向静脉窦外流并引起脑积水。由于骨骼和蛛网膜颗粒具有相同的胶原类型,研究者评估了SAH后骨密度和分流依赖性脑积水的可能关系。相关研究结果于近期发表在Stroke杂志。

蛛网膜下腔出血(SAH)后蛛网膜颗粒的病理性阻塞可阻碍脑脊液向静脉窦外流并引起脑积水。由于骨骼和蛛网膜颗粒具有相同的胶原类型,研究者评估了SAH后骨密度和分流依赖性脑积水的可能关系。相关研究结果于近期发表在Stroke杂志。

研究者测量了SAH患者入院脑计算机断层扫描时额颅骨的Hounsfield单位,根据受试者的测量特征曲线分析以确定颅骨的最佳Hounsfield单位界值,进而预测大样本登记处患者的骨质减少和骨质疏松症。根据最佳颅骨Hounsfield单位界值,受试者被分为假想正常,骨量减少和骨质疏松症。使用逻辑回归估计优势比(OR),以确定骨质疏松症是否为SAH手术夹闭后发生分流依赖性脑积水的独立预测因素。

结果,9年期间,共有447例(存活≥14天)动脉瘤破裂的SAH患者接受手术夹闭术。研究者发现,假设的骨质疏松症是校正包括年龄(OR=2.08;95%CI:1.06~4.08;P = 0.032)在内其他预测因素后的SAH动脉瘤夹闭术后分流依赖性脑积水的独立预测因子。

此研究证实了SAH后可能的骨质疏松症与脑积水的可能关系。入院脑部计算机断层扫描Hounsfield单位测量可有助于预测骨质疏松症或疑似骨质疏松症患者SAH临床中的脑积水。

原始出处:
Myung-Hoon Han, Yu Deok Won, Min Kyun Na, et al. Association Between Possible Osteoporosis and Shunt-Dependent Hydrocephalus After Subarachnoid Hemorrhage. Stroke. June 26, 2018.

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