Chinese Journal of Contemporary Neurology and Neurosurgery ›› 2018, Vol. 18 ›› Issue (11): 807-812. doi: 10.3969/j.issn.1672-6731.2018.11.009

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The influence of enlarged perivascular spaces on the prognosis of patients with intracerebral hemorrhage

OU Ru1, TANG Ya-mei2, LI Fei3   

  1. 1Department of Neurology, Guangdong Tongjiang Hospital, Foshan 528000, Guangdong, China
    2Department of Neurology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou 510120, Guangdong, China
    3Department of Neurology, People's Hospital of Nanhai District, Foshan 528000, Guangdong, China
  • Online:2018-11-25 Published:2018-12-02
  • Contact: TANG Ya-mei (Email: yameitang@hotmail.com)
  • Supported by:

    This study was supported by the National Natural Science Foundation of China (No. 81471249), the National Natural Science Foundation of China for Outstanding Young Scholars (No. 81622041), Natural Science Foundation of Guangdong Province, China (No. 2014A030313120), and Scientific Research Project of Foshan Health Bureau, Guangdong Province, China (No. 20160216).

扩大的血管周围间隙对脑出血患者预后的影响

欧茹, 唐亚梅, 李飞   

  1. 528000 佛山,广东同江医院神经内科(欧茹);510120 广州,中山大学孙逸仙纪念医院神经内科(唐亚梅);528000 广东省佛山市南海区人民医院神经内科(李飞)
  • 通讯作者: 唐亚梅(Email:yameitang@hotmail.com)
  • 基金资助:

    国家自然科学基金资助项目(项目编号:81471249);国家自然科学基金优秀青年科学基金资助项目(项目编号:81622041);广东省自然科学基金资助项目(项目编号:2014A030313120);广东省佛山市卫生和计生局医学科研课题(项目编号:20160216)

Abstract:

Objective To investigate the impact of enlarged perivascular spaces (EPVS) on the prognosis of patients with intracerebral hemorrhage (ICH). Methods A total of 306 ICH patients were enrolled in this study. The bleeding volume was calculated by Tada formula based on CT. The number and grade of EPVS were evaluated by MRI. Participants were assessed at 90 d after onset for functional outcome by the modified Rankin Scale (mRS) and quality of life by EuroQol Five Dimensions Questionnaire (EQ-5D). The cerebrovascular events were recorded within one-year follow-up. Results Patients were divided into EPVS group (N = 129) and non-EPVS group (N = 177). The rate of poor functional outcome [75.97% (98/129) vs. 36.16% (64/177); χ2 = 47.469, P = 0.000] and the rate of poor quality of life [44.19%(57/129) vs. 20.34% (36/177); χ2 = 20.058, P = 0.000] in EPVS group were significantly higher than those in non-EPVS group. Subgroup analysis showed the rate of poor functional outcome [52% (39/75) vs. 77.78% (42/54); χ2 = 8.929, P = 0.003] and the rate of poor quality of life [25.33% (19/75) vs. 55.56% (30/54); χ2 = 12.173, P = 0.000] in mild EPVS group were significantly lower than those in severe EPVS group. During follow-up period, the recurrence rate of hemorrhagic stroke [6.98% (9/129) vs. 1.13% (2/177); adjusted χ2 =5.770, P = 0.016] and ischemic stroke [12.40% (16/129) vs. 2.82% (5/177); χ2 = 10.710, P = 0.001] in EPVS group were significantly higher than those in non-EPVS group. Conclusions ICH patients with EPVS have poor functional outcome, poor quality of life and high risk of recurrent cerebrovascular events within one year. EPVS can be the predictor for poor prognosis of ICH patients. 

Key words: Enlarged perivascular spaces (not in MeSH), Cerebral hemorrhage, Prognosis

摘要:

目的 探讨扩大的血管周围间隙(EPVS)对脑出血患者预后的影响。方法 共306例脑出血患者以 CT 结果为依据,采用多田公式计算脑出血量,MRI评价扩大的血管周围间隙数目和分级,于发病后90 d采用改良 Rankin量表(mRS)和欧洲五维健康量表(EQ-5D)评价功能恢复和生活质量,随访1年记录 1 年内脑卒中复发情况。结果 共 306 例患者根据有无扩大的血管周围间隙分为 EPVS 组(129 例)和无 EPVS 组(177 例),EPVS 组患者功能预后不良比例[75.97%(98/129)对 36.16%(64/177);χ2 = 47.469,P = 0.000]和生活质量较差比例[44.19%(57/129)对 20.34%(36/177);χ2 = 20.058,P = 0.000]均高于无EPVS 组。亚组分析显示,EPVS 轻度组患者功能预后不良比例[52%(39/75)对 77.78%(42/54);χ2 = 8.929,P = 0.003]和生活质量较差比例[25.33%(19/75)对55.56%(30/54);χ2 = 12.173,P = 0.000]均低于重度组。EPVS 组脑出血 1 年内出血性卒中复发率[6.98%(9/129)对 1.13%(2/177);校正χ2 = 5.770,P = 0.016]和缺血性卒中复发率[12.40%(16/129)对 2.82%(5/177);χ2 = 10.710,P = 0.001]均高于无 EPVS组。结论 存在扩大的血管周围间隙的脑出血患者预后不良,生活质量较差,1 年内脑卒中复发率较高;扩大的血管周围间隙可以作为脑出血患者预后不良的预测因素。

关键词: 扩大的血管周围间隙(非 MeSH 词), 脑出血, 预后