自发性脑出血与淀粉样脑血管病相关性研究

The study of association between spontaneous intracranial hemorrhage and cerebral amyloid angiopathy

目的了解自发性腑出血患者巾淀粉样脑血管病（CAA）的发病率。方法105例影像学证实为自发性脑出血的患者来自全国30家医院，其中男68例，女37例，平均年龄（55±13）岁。人组患者均接受了急诊开颅手术，标本取自经皮层造瘘的脑组织碎片，通过刚果红染色和β淀粉样蛋白（Aβ）免疫组化染色明确是否存在淀粉样变性，初步得出白发性脑出血患者中存在CAA所占的比例。结果105例患者中15例为CAA，占14．29％；自发性脑出血发病男：女比值为68：37，其中CAA阳性者男：女为8：7；按年龄段划分又可分为：〈40岁组14．29％（1／7），40～49岁组占20．83％（5／24），50～59岁组17．14％（6／35），60～69岁组占4．17％（1／24），70岁以上年龄组8．00％（2／25）。结论手术治疗的自发性脑出血患者中约14．29％与CAA相关。

Objective To get the general situation of the cerebral amyloid angiopathy （CAA） incidence in spontaneous intracranial hemorrhage （SlCH） patients receiving surgical treatment in Chinesepeople. Methods During the period May 2008 and March 2009, 105 patients admitted to 30 hospitals throughout China for acute SICH were studied, including 68 male and 37 female mean aged （55 ± 13） .The patients were suffered from SICH proved by computed tomography scan （CT）. Emergent craniotomies for hemorrhage evacuation were performed for these patients within 72 h after hemorrhage onset and brain tissue of the cortex was also obtained meanwhile. A further histological study, Congo red stained and Aβ immunochemistry included was followed to verify the existence of CAA. Result Fifteen out of the 105 cases is identified as CAA positive, and the total ratio is 14. 29%. As to age groups, about 20. 83% （5/24） of the cases of the 40-49 years old group have been diagnosed as CAA, 17. 14% （6/35） of the 50 -59 years old group,4. 17% （1/24） of the 60 -69 group,and for those older than 70 years, the ratio is 8.00% （2/25）. Conclusion We come to the conclusion that 14. 29% of the surgically treated SICH events might be closely related to CAA.