摘要
目的 探讨脑静脉窦血栓形成（CVST）患者短期转归不良的危险因素. 方法 选择郑州大学第一附属医院自2010年1月至2014年10月收治的143例CVST患者,根据患者出院时改良Rankin量表（mRS）评分将患者分为转归良好组（0～2分）和转归不良组（3～6分）.比较2组患者的基本临床资料;多变量Logistic回归分析影响患者转归的独立危险因素. 结果 出院时转归良好患者118例,转归不良患者25例.与转归良好组比较,转归不良组患者癫痫发生率、血清D-二聚体水平、出血性脑卒中比例较高,差异有统计学意义（P＜0.05）.多因素Logistic回归分析显示癫痫、昏迷、失语、血清D-二聚体水平、出血性脑卒中是CVST患者短期转归不良的独立危险因素.受试者工作特征（ROC）曲线分析显示D-二聚体为3.175 μg/mL时,其预测CVST短期转归不良的敏感度和特异度分别为68.0％和85.6％. 结论 癫痫、昏迷、失语、血清D-二聚体水平、出血性脑卒中是CVST患者短期转归不良的独立危险因素.
Objective To investigate the risk and predictive factors of short-term poor outcomes in patients with cerebral venous sinus thrombosis （CVST）.Methods A total of 143 patients diagnosed as having CVST within 30 days onset,admitted to our hospital from January 2010 to October 2014,were chosen in our study;the clinical outcomes were assessed with modified Rankin scale （mRS） at discharge,and these patients were divided into either a good outcome group （mRS 0-2） or a poor outcome group （mRS 3-6）.The related factors,such as demographic,etiology,clinical features and treatments,were compared between the two groups.Multivariate Logistic regression analysis was used to determine the independent risk factors for short-term poor outcomes in patients with CVST.Results A total of 118 had good outcomes and 25 had poor outcomes.As compared with patients with poor outcomes,patients with good outcomes had significantly higher incidence rate of epilepsy,serum D-dimer level and ratio of hemorrhagic stroke （P〈0.05）.In Logistic regression analysis,epilepsy （OR=15.511,95%CI：3.749-64.169）,coma（OR=4.484,95%CI：1.067-18.847）,aphasia（OR=11.127,95%CI：1.137-108.857）,baseline D-dimer level （OR=1.178,95%CI：1.009-1.377） and intracranial hemorrhage （OR=0.149,95% CI：0.042-0.525） were identified as independent predictors of poor prognosis.Receiver operating characteristic curve showed mat when the cutoff value of the baseline D-dimer was 3.175 μg/mL,the sensitivity and specificity of predicting short-term poor outcome of CVST were 68.0% and 85.6% respectively.Conclusion Epilepsy,coma,aphasia,baseline D-dimer level and intracranial hemorrhage are independent predictors of poor prognosis.
出处
《中华神经医学杂志》
CAS
CSCD
北大核心
2015年第6期582-585,共4页
Chinese Journal of Neuromedicine
关键词
脑静脉窦
血栓形成
颅内
预后
Sinus thrombosis
Thrombogenesis
The intracranial
Prognosis
