颅内静脉窦血栓形成预后不良的临床与影像学分析

Clinical and imaging analysis of poor prognosis of intracranial venous sinus thrombosis

目的 通过回顾性分析不同颅内静脉窦血栓患者的临床及影像学资料,进一步探讨其预后不良的特征性相关因素。方法 对颅内静脉窦血栓患者的临床以及影像学资料进行分组,预后良好组(MRS≤2分)和预后不良组(MRS> 2分),并对可能影响患者预后的临床相关因素进行单因素和多因素分析,探讨临床以及影像危险因素与疾病预后转归的关系。结果 纳入分析因素包括性别、昏迷、癫痫、头痛、视力障碍、认知障碍、侧支循环。单因素分析显示:昏迷(P=0. 008)、癫痫(P=0. 027)、视力障碍(P=0. 016)、侧支循环(P=0. 004)、出血性卒中(P=0. 031),两组间比较有统计学意义。多因素Logistic回归分析显示:昏迷(OR=20,P=0. 0016)、侧支循环(OR=0. 056,P=0. 0004)为静脉窦形成预后不良的独立危险因素。结论 昏迷、颅内静脉窦侧支循环不良是静脉窦血栓形成短期预后不良的独立危险因素。

Objective To explore the risk factors associated with poor prognosis of Cerebral Venous Sinus Thrombosis.Methods A total of 104 patients diagnosed as CVST in the neurology of first affiliated hospital in Henan university from 2008 to 2017 were enrolled.The patients were divided into favorable prognosis group(mRS≤2)and unfavorable prognosis group(mRS>2)according to mRS.To explore the clinical and image risk factors and prognosis of disease outcome.Univariate analysis uses chi square analysis,whlie multivariate analysis takes Logistic regression analysis.Results A total of 104 cases with clinical and imaging data of venous sinus thrombosis patients,women account for 50.6%in favorable prognosis group(MRS≤2),as unfavorable prognosis group(MRS≤2)was 46.7%;Univariate analysis showed that there were much more difference between good prognosis and those with poor prognosis:coma(P=0.008),epilepsy(P=0.027),visual impairment(P=0.016),collateral formation(P=0.004),hemorrhagic stroke(P=0.031);In Multiariable logistic regression,coma(OR=20,P=0.0016),collateral formation(OR=0.056,P=0.0004)were independent risk factors of poor prognosis in CVST patients.Conclusion Coma,poor collateral circulation are independent predictors of poor prognosis in CVST patients.