CT血管造影点征与自发性脑出血患者神经功能的相关研究被引量：12

Study on the Correlation between CT Angiography Spot Sign and Neurological Function in Patients with Spontaneous Cerebral Hemorrhage

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摘要目的对自发性脑出血(cerebral hemorrhage,ICH)患者出现CT血管造影(computed tomography angigraphy,CTA)点征阳性与阴性的相关因素进行分析;探讨CTA点征预测脑出血血肿扩大、预估神经功能和临床预后;指导临床治疗。方法分析重庆市巴南区人民医院神经内科及神经外科共66例脑出血患者基本信息、既往史,生命体征、实验室、影像资料及随访1月预后情况;用单因素分析CTA点征阳性组和阴性组的基线特征;计算CTA点征预测血肿扩大的特异度、灵敏度、阳性预测价值、阴性预测价值。根据P值观察点征预测早期神经功能恶化及对1月预后的评估价值。结果点征阳性组与点征阴性组在格拉斯哥昏迷量表(GCS)评分、国立卫生研究院卒中量表(NIHSS)评分及ICH体积间比较,差异有统计学意义(P<0.05);点征预测血肿扩大的阳性预测价值62.5%,阴性预测价值80.95%,灵敏度65.21%,特异度79.07%;点征阳性组中,初诊血肿体积与复诊血肿体积间差异有统计学意义(P<0.05),而点征阴性组中则差异无统计学意义(P>0.05);点征阳性组与点征阴性组在早期神经功能恶化方面及1月后mRS评分间的比较,差异均有统计学意义(P<0.05)。结论CTA点征阳性较点征阴性的脑出血患者临床表现更严重;CTA点征可以预测血肿扩大;脑出血患者出现CTA点征阳性可能预示早期出现神经功能恶化的风险高,1月后的临床预后更差。 Objective To analyze the positive and negative correlative factors of CT angiography spot sign in patients with spontaneous cerebral hemorrhage, explore the value of CT angiography spot sign in predicting hematoma enlargement, neurological function and clinical prognosis, and provide guidance for the clinical treatment. Methods A total of 66 patients with cerebral hemorrhage treated in Banan People's Hospital of Chongqing were selected, and their general information, medical history, vital signs, laboratory data, radiographic findings and prognosis of 1-month follow-up were analyzed retrospectively. The baseline characteristics of positive and negative CT angiography spot sign were analyzed by the univariate analysis, and the specificity, sensitivity, positive predictive value and negative predictive value of hematoma enlargement were predicted by calculating CT angiography spot sign. P value was used to evaluated the value of CT angiography spot sign in predicting the early deterioration of neurological function and the prognosis of 1-month follow-up. Results There were significant differences in the Glasgow coma score, NIHSS score and ICH volume between the groups of positive and negative CT angiography spot sign. The positive predictive value, negative predictive value, sensitivity and specificity of CT angiography spot sign in predicting hematoma enlargement were 62.5%, 80.95%, 65.21% and 79.07%, respectively. There were significant differences between the volumes of newly-diagnosed and re-diagnosed hematoma in the positive CT angiography spot sign group, while there were not in the negative CT angiography spot sign group. There were significant differences in the early deterioration of neurological function and the mRS score after 1 month between the groups of positive and negative CT angiography spot sign. Conclusion The clinical manifestations of the cerebral hemorrhage patients with positive CT angiography spot sign are more serious than those with negative CT angiography spot sign. Positive CT angiography spot sign may indicate a higher risk of early neurological function deterioration and worse clinical prognosis after 1 month in patients with cerebral hemorrhage.

作者谭郎敏肖静唐明山邹耀兵 Tan Langmin;Xiao Jing;Tang Mingshan;Zou Yaobing(Department of Neurology, Banan People's Hospital of Chongqing, Chongqing 401320, China)

机构地区重庆市巴南区人民医院神经内科

出处《成都医学院学报》 CAS 2019年第4期454-458,共5页 Journal of Chengdu Medical College

基金重庆市卫生计划生育委员会基金项目(No:2016MSXM153)

关键词脑出血 CTA点征预后血肿扩大 Cerebral hemorrhage CT angiography spot sign Prognosis Hematoma enlargement

分类号 R743.34 [医药卫生—神经病学与精神病学]

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参考文献3

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