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Stroke:存在脑小血管疾病的急性脑出血患者,预后不良

2016-05-24 MedSci MedSci原创

背景:脑小血管病(SVD)相关的结构变化包括白质病变(WML),腔隙性脑梗死和脑萎缩,对急性脑出血的预后的影响尚不清楚。研究者在急性脑出血后强化降压的大型试验(INTERACT2试验),就早期强化降压治疗的不同作用,确定的脑SVD的CT表现和预后的相关性。方法:3个独立的神经科临床医师,根据基线脑CT(脑出血内6小时)评估WML分级(van Swieten量表),腔隙性梗死卒中和脑萎缩(2线性测量

背景:脑小血管病(SVD)相关的结构变化包括白质病变(WML),腔隙性脑梗死和脑萎缩,对急性脑出血的预后的影响尚不清楚。研究者在急性脑出血后强化降压的大型试验(INTERACT2试验),就早期强化降压治疗的不同作用,确定的脑SVD的CT表现和预后的相关性。

方法:3个独立的神经科临床医师,根据基线脑CT(脑出血内6小时)评估WML分级(van Swieten量表),腔隙性梗死卒中和脑萎缩(2线性测量和视觉等级)。

结果:WML分级和脑萎缩2线性测量与90天死亡或重大残疾相关:WML(3级和4级VS 0级),额比率及第三脑室外侧裂的距离(最严重脑萎缩四分位数 VS 最轻四分位数)的多变量校正OR值分别为:1.42(95%CI,1.02-1.98)、1.47(1.08-1.99)和1.64(1.21-2.22)。腔隙性梗死和急性脑出血患者预后没有任何相关性。在强化降压治疗组和其他亚组脑SVD没有显著差异。

结论:已有脑SVD表现即WML和脑萎缩预测急性脑出血不良预后差。根据INTERACT2协议强化降低血压,患有脑SVD的患者没有明显危险。

原始出处:

Sato S, Delcourt C, et al. Significance of Cerebral Small-Vessel Disease in Acute Intracerebral Hemorrhage. Stroke. 2016 Mar.

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