首诊CTA点征对原发性脑出血患者血肿扩大、院内死亡及不良预后的预测(1)
[摘要] 目的 探讨CTA点征数量、最长轴线尺寸及CT值与脑出血患者脑血肿、院内死亡及不良预后的关系。 方法 对2015年12月～2016年12月本院收治脑出血患者6小时内行脑部CT扫描与CTA检查，并在发病24小时后行CT扫描，确定50名血肿扩大与50名血肿未扩大患者，比较患者一般情况、CT点征及血肿容量与血肿扩大、院内死亡及不良预后的差别，进一步多因素分析CT点征数量、最长轴线尺寸及CT值与血肿扩大、院内死亡及不良预后的关系。 结果 单因素分析中，脑血肿容量、首诊CT点征阳性、点征个数、最大轴线尺寸以及CT值与脑血肿扩大有关(P<0.05)。脑血肿容量、首诊CT点征阳性、点征个数与脑出血病人死亡与不良预后有关(P<0.05)。多因素分析显示，CT点征最大轴线尺寸(OR=3.497，P=0.007，95%CI：1.411 ～ 8.663)和CT值(OR=1.113，P=0.005，95%CI：1.033 ～ 1.198)为脑血肿扩大的危险因素。血肿容量(OR=1.069，P=0.013，95%CI：1.014 ～ 1.126)和CT点征个数(OR=15.868，P=0.009，95%CI：1.965 ～ 128.140)为脑出血病人死亡的危险因素。血肿容量(OR=1.058，P=0.016，95%CI：1.010 ～ 1.108)和CT点征个数(OR=4.729，P=0.045，95%CI：1.035 ～ 21.608)为脑出血病人死亡的危险因素。 结论 CT点征最长轴向尺寸和CT值可预测脑血肿扩大的风险，血肿容量和CT点征个数可预测脑出血院内死亡及不良預后的风险。
[关键词]原发性脑出血；CT点征；血肿扩大；院内死亡；不良预后
[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616(2017)13-181-05
[Abstract] Objective To explore association between characteristics of spot sign and hematoma expansion，in-hospital mortality and poor outcome in spontaneous intracerebral hemorrhage. Methods CT scans and CTA were performed on patients with spontaneous intracerebral hemorrhage between December 2015 and December 2016 on admission，and another CT scan was performed 24 hours after onset to determine hematoma expansion.50 patients with hematoma expansion and 50 without were finally included in our study.Univariate analyses and multivariate analysis were performed to determine the risk factors of hematoma expansion，in-hospital mortality and poor outcome. Results In the single factor analysis， the volume of brain hematoma，the positive number of CT points，the number of dots，the maximum axis size and the CT value were related to the enlargement of hematoma (P<0.05).The volume of brain hematoma，the positive number of CT points and the number of dots were related to the mortality and adverse prognosis of patients with cerebral hemorrhage (P<0.05).Multivariate analysis showed that the maximum axis size(OR=3.497，P=0.007，95%CI：1.411-8.663) and CT(OR=1.113，P=0.005，95%CI：1.033-1.198) of CT points were risk factors for enlargement of brain hematoma.The volume of hematoma (OR=1.069，P=0.013，95%CI：1.014-1.126) and the number of CT points (OR=15.868，P=0.009，95%CI：1.965-128.140) were risk factors for mortality in patients with cerebral hemorrhage.The volume of hematoma(OR=1.058，P=0.016，95%CI：1.010-1.108) and the number of CT points (OR=4.729，P=0.045，95%CI：1.035-21.608) were risk factors for mortality in patients with cerebral hemorrhage. Conclusions The CT sign，the longest axis dimension and the CT value can predict the risk of enlargement of the brain hematoma.The volume of hematoma and the number of CT points can predict the risk of in-hospital death and adverse prognosis in cerebral hemorrhage., 百拇医药(林发牧 许小兵 谢国强)
[关键词]原发性脑出血；CT点征；血肿扩大；院内死亡；不良预后
[中图分类号] R743.3 [文献标识码] A [文章编号] 2095-0616(2017)13-181-05
[Abstract] Objective To explore association between characteristics of spot sign and hematoma expansion，in-hospital mortality and poor outcome in spontaneous intracerebral hemorrhage. Methods CT scans and CTA were performed on patients with spontaneous intracerebral hemorrhage between December 2015 and December 2016 on admission，and another CT scan was performed 24 hours after onset to determine hematoma expansion.50 patients with hematoma expansion and 50 without were finally included in our study.Univariate analyses and multivariate analysis were performed to determine the risk factors of hematoma expansion，in-hospital mortality and poor outcome. Results In the single factor analysis， the volume of brain hematoma，the positive number of CT points，the number of dots，the maximum axis size and the CT value were related to the enlargement of hematoma (P<0.05).The volume of brain hematoma，the positive number of CT points and the number of dots were related to the mortality and adverse prognosis of patients with cerebral hemorrhage (P<0.05).Multivariate analysis showed that the maximum axis size(OR=3.497，P=0.007，95%CI：1.411-8.663) and CT(OR=1.113，P=0.005，95%CI：1.033-1.198) of CT points were risk factors for enlargement of brain hematoma.The volume of hematoma (OR=1.069，P=0.013，95%CI：1.014-1.126) and the number of CT points (OR=15.868，P=0.009，95%CI：1.965-128.140) were risk factors for mortality in patients with cerebral hemorrhage.The volume of hematoma(OR=1.058，P=0.016，95%CI：1.010-1.108) and the number of CT points (OR=4.729，P=0.045，95%CI：1.035-21.608) were risk factors for mortality in patients with cerebral hemorrhage. Conclusions The CT sign，the longest axis dimension and the CT value can predict the risk of enlargement of the brain hematoma.The volume of hematoma and the number of CT points can predict the risk of in-hospital death and adverse prognosis in cerebral hemorrhage., 百拇医药(林发牧 许小兵 谢国强)