CMBs对自发性脑出血患者血肿进展的预测价值

目的:探讨脑内微出血对自发性脑出血患者血肿进展的预测价值。方法:选取2010年7月至2013年7月我院收治的自发性脑出血患者110例,入院及72小时内复查CT和MR,根据有无血肿扩大将患者分为血肿扩大组和非血肿扩大组,并比较两组患者年龄、性别、血压,血肿量,血肿形态,有无糖尿病以及脑内微出血率进行比较,并通过回归分析确定影响脑出血患者血肿扩大的危险因素。结果:血肿扩大组与非血肿扩大组的性别比例、糖尿病比例、吸烟比例、心脏病比例、入院时舒张压和收缩压和72h后的舒张压和收缩压的差异均无统计学意义(P0.05),而血肿扩大组患者入院时的血肿体积、形态和脑内微出血的比例要明显高于非血肿扩大组的患者,且差异具有统计学意义(P0.05);Logistic回归模型分析,影响自发性脑出血血肿扩大的危险因素有脑内微出血、血肿体积和血肿形态。结论:自发性脑出血患者脑内微出血的存在和多少可作为血肿扩大的风险指标。

The Predictive Value of Cerebral Microbleeds （CMBs） on Hematoma in the Patients with Hypertensive Cerebral Hemorrhage

ObjectiveTo investigate the predictive value of cerebral microbleeds on hematoma in the patients with hypertensive ce-rebral hemorrhage. Method110 patients from July 2011 to July 2013 in our hospital were selected and the hematoma volume was de-tected by CT and MRI in 30min on admission, and blood pressure, disease history and genderdistribution were recorded.The patients were divided intohematoma expansion group and hematoma non- expansion groups according CT and MRI under review after 72h, the proportion of cerebral microbleeds was compared in two groups, as well as determined by regression analysis of patients with hy-pertensive cerebral hemorrhage expanding hematoma could predict risk factors. ResultsGender ratio, history of stroke ratio, the propor-tion of diabetes, smoking rates, the proportion of heart disease, diastolic and systolic blood pressure on admission and 72h diastolic and systolic blood pressure in two groups were not significantly different （P〉0.05）. The volume of admission hematoma and the ratio of CMBs in hematoma expansion group were significantly higher than the patients in hematoma non-expansion groups, and the differ-ences were statistically significant （P〈0.05）. Logistic multiple regressionshowed that CMBs was theonlyrisk factor which could enter regression equation（OR=2.317, P〈0.001）. Conclusion CMBs patients with Hypertensive Cerebral Hemorrhage may predictthehigh risk of hematoma expansion.