眼跳潜伏期预测动脉瘤性蛛网膜下腔出血后迟发性脑缺血的研究

Prediction of delayed cerebral ischemia after aneurysmal subarachnoid hemorrhage with saccade latency

目的探讨眼跳潜伏期对动脉瘤性蛛网膜下腔出血(SAH)后迟发性脑缺血(DCI)的预测作用。方法回顾性选择2012年1月~2016年12月来我院接受治疗的SAH患者110例。根据患者入院后30天内有无并发迟发性脑缺血(DCI)分为并发DCI组(n=40)和未并发DCI组(n=70)。应用单因素、多因素非条件Logistic回归分析探讨影响SAH患者DCI发生的危险因素。结果眼跳频率、眼跳总时间、单次眼跳平均时间、眼跳总幅度、眼跳平均幅度、眼跳平均速度、眼跳潜伏期预测SAH后DCI发生的诊断界值分别为2.65次/s、1685.45 ms、39.03 ms、553.25°、8.05°、118.35°/s、375.42 ms。Hunt-Hess分级≥Ⅲ级、Fisher分级≥Ⅲ级、脑积水程度(中度、重度)、眼跳潜伏期≥375.42 ms会增加SAH后DCI发生风险(P<0.05)。结论眼跳潜伏期可预测SAH后DCI发生。

Objective To investigate the predictive value of saccade latency for delayed cerebral ischemia （DCI） after aneurysmal subarachnoid hemorrhage （SAH）. Methods A total of 110 patients with SAH who received treatment in our hospital from January 2012 to December 2016 were selected as study subjects. According to the presence or absence of concurrent DCI within 30 days after admission, they were divided into DCI group （n = 40） and non-DCI group （n = 70）. Univariate and multivariate unconditional logistic regression analyses were used to investigate the risk factors for DCI in patients with SAH. Results The diagnostic cut-off values of saceade frequency, total time of saceade, mean time of single saecade, total amplitude of saecade, mean amplitude of saecade, mean saccade speed, and saccade latency for DCI after SAH were 2.65 times/s, 1685.45 ms, 39.03 ms, 553.25°, 8.05°, 118.35°/s, and 375.42 ms, respectively. The univariate and multivariate logistic regression analyses showed that Hunt-Hess grade ≥ Ⅲ, Fisher grade ≥Ⅲ , degree of hydrocephalus （ moderate or severe） , and saecade latency ≥ 375.42 ms could increase the risk of DCI after SAH （ P 〈 0.05 ）. Conclusions Saeeade latency can predict the development of DCI after SAH.