脑静脉及静脉窦血栓形成的预后研究

Prognosis of Cerebral Venous Sinus Thrombosis

目的考察脑静脉及静脉窦血栓形成(CVST)的远期预后,并探索与不良结局相关的预测因素。方法本研究采用前瞻性登记的方法,对纳入的脑静脉及静脉窦血栓形成患者进行连续性随访。研究的初级终点指标是发病6个月时的死亡/残疾(改良Rakin评分>2)。采用多因素logistic回归模型考察与预后独立相关的因素。结果研究共纳入了52例脑静脉及静脉窦血栓形成患者。6个月复发率和病死率分别为13.5%和7.7%,6个月时的死亡/残疾率为29.9%。多因素logistc回归分析显示,伴有颅内实质病灶[OR=14.62.,95%CI(2.36,90.36)],确诊延迟>16天[OR=13.14,95%CI(1.90,90.84)]与CVST患者6个月的结局独立相关。结论脑静脉及静脉窦血栓形成在我国仍是一种致死致残性疾病,远期预后较国外报道差,原因可能与本组患者确诊时间晚,延误了早期治疗有关。

Objective To investigate the long-term prognosis of cerebral venous sinus thrombosis （CVST） and to identify the early predictors of poor outcome. Methods We performed a prospective register study on the prognosis of CVST patients. All patients were followed up continuously. The primary endpoint was death or dependence as assessed by the modified Rankin Scale （mRS） score 〉2 at month 6. A multivariable logistic regression model was applied to identify the predictors of outcome. Results A total of 52 CVST patients were included. The rates of recurrence and death at month 6 were 13.5% and 7.7%, respectively, and 29.9% of the patients were dead or dependent at month 6. The multivariable logistic regression analysis revealed that the predictors of death or dependence at month 6 were intracranial parenchymal lesion （OR=14.62, 95%CI 2.36 to 90.36） and delayed diagnosis （OR=13.14, 95%CI 1.90 to 90.84）. Conclusion In China, CVST is still a disease that may lead to death or dependence. Its long-term prognosis is relatively poor compared to that reported in western patients. This difference may due to the delayed diagnosis of CVST in China.