渗透性表面面积指数对幕上脑出血早期血肿扩大的预测研究

Study of the Correlation Between Permeability-Surface Area Product and Hematoma Expansion in Acute Intracerebral Hemorrhage

目的 探讨渗透性表面面积指数(permeability-surface area product index,PSI)预测幕上脑出血早期血肿扩大的敏感程度。方法 连续入组2007年9月～2012年4月首都医科大学附属北京天坛医院急性幕上脑出血患者40例(发病6h内),比较入院时及发病24h时的计算机断层扫描(computedtomography,CT)的血肿体积,根据血肿体积增加是否大于33%者分为血肿扩大组和未扩大组。通过计算机断层扫描血管成像(computedtomographyangiography,CTA)的点征和灌注CT的渗透性表面面积及PSI,比较PSI预测血肿扩大的灵敏度及特异度。结果 血肿扩大的发生率为45%,血肿扩大组水肿组织PSI为(2.600.51)高于未扩大组(2.270.34)(P=0.040);水肿组织PSI诊断血肿扩大的灵敏度为88.89%,特异度为68.18%。结论 脑出血急性期血肿扩大后PSI增加,PSI预测幕上脑出血急性期血肿扩大敏感性高。

Objective To investigate the sensitivity between permeability-surface area product index and hematoma expansion in acute intracerebral hemorrhage. Methods Forty patients with acute intracerebral hemorrhage（onset within 6 hours） who hospitalized in Beijing Tiantan Hospital from September 2007 to April 2012 were included in this study. Computed tomography（CT） perfusion was taken within 6 hours after the patients＇ symptom onset, and CT scan was rechecked at 24 hours after the patients＇ symptom onset. The correlation between permeability-surface area product and hematoma expansion was evaluated. Results The incidence rate of hematoma enlargement was 45%. The permeability-surface area product index（PSI）（2.60±0.51） of the edema tissue of patients with hematoma enlargement was bigger than those without（2.27±0.34）（P=0.040）. In the diagnosis of hematoma enlargement, the sensitivity of PSI of edema was 88.89%, the specificity was 68.18%. Conclusion In the acute phase of cerebral hemorrhage, PSI is increased, and PSI is very sensitive in prediction of the occurrence of hematoma enlargement.