复发性脑出血临床特点和危险因素分析

Clinical features and risk factors of recurrent intracerebral hemorrhage

目的探讨复发性脑出血(ICH)临床特点和相关危险因素。方法回顾性分析62例复发性脑出血患者临床资料,并与同期住院的首发脑出血患者进行对照研究。结果62例患者复发间隔时间为(3.9-3.7)年,38.19%在1年以内复发。复发类型以基底节—基底节最多见,其次为基底节—丘脑和基底节—脑叶,多在对侧复发,很少在同一部位复发。与首发患者相比,复发性脑出血患者多有高血压病,病程较长且控制不良,并与糖尿病,高血脂等有关;且病情重,预后差。多变量Logistic分析显示高血压病程与复发脑出血呈正相关。结论脑出血后5年内复发率高,积极有效控制高血压和其他因素,可以预防脑出血复发,改善预后。

[Objective] To investigate the clinical features and risk factors of recurrent intracerebral hemorrhage(ICH).[Methods] Clinical data of 62 patients with recurrent ICH were analyzed and compared with those of patients with first-ever ICH.[Results] Recurrences were seen in 62 patients.The mean interval between episodes was(3.9±3.7)years.38.19% recurrence occurred within 1 year.The most common pattern of recurrence was 'ganglionic-ganglionic',followed by 'ganglionic-thalamic' and 'ganglionic-lobar'.Most recurrences occurred contralaterally and seldom at the same site as the first episode.In contrast to those with first-ever ICH,patients with recurrent ICH showed a significantly higher frequency and longer course of hypertension,all with a poor control,who have a relationship with diabetes mellitus,high blood fat et al and have severe state and bad prognosis.Multivariate logistic analysis showed that the hypertension course associated with the recurrence of ICH was positively.[Conclusion] The risk of recurrence of ICH is relatively high with in the first 5 years after the previous hemorrhage.Hypertension and other risk factots control may help the prevention of recurrent ICH and improve prognosis.