CT平扫非均一密度血肿与原发性基底节区脑出血患者预后的关系

Relationship CT scan non-uniform density hematoma and clinical prognosis of patients with primary cerebral hemorrhage in basal ganglia between on plain

目的探讨CT平扫非均一密度血肿与原发性基底节区脑出血患者临床预后的关系。方法选择2014年1月~2018年10月安徽省芜湖市第一人民医院收治的原发性基底节区脑出血6h内患者146例,根据患者改良Rankin量表(mRS)将其分为预后良好组(0~2分)77例和预后不良组(3~6分)69例;采用单因素方差分析及多因素Logistic回归分析筛选不良临床预后的危险因素。结果预后不良组患者入院时收缩压、基线美国国立卫生研究院卒中量表(NIHSS)评分、非均一密度血肿阳性率、血肿混杂征阳性率、血肿黑洞征阳性率、早期神经功能恶化率、血肿扩大率、3周NIHSS评分、mRS评分均高于预后良好组,而首次CT完成时间短于预后良好组,基线血肿体积大于预后良好组,差异均有统计学意义(均P<0.05)。非均一密度血肿阳性和入院时收缩压均是基底节区脑出血患者血肿扩大、早期神经功能恶化及6个月不良预后的影响因素(P<0.05)。结论CT非均一密度血肿(黑洞征或混杂征)是自发性脑出血预后不良的危险因素。

Objective To explore the relationship between non-uniform density hematoma on plain CT scan and the clinical prognosis of patients with primary cerebral hemorrhage in basal ganglia. Methods From January 2014 to October 2018, a total of 146 patients with primary cerebral hemorrhage in basal ganglia and within 6 h admitted to Wuhu NO.1 People′s Hospital were selected. According to the modified Rankin Scale (mRS), they were divided into 77 patients of good clinical prognosis group (0-2 points) and 69 patients of poor prognosis group (3-6 points). One-way ANOVA and multivariate Logistic regression analysis were used to screen risk factors for poor clinical prognosis. Results The systolic blood pressure on admission, baseline of the national institutes of health stroke scale (NIHSS) scores, positive rate of non-uniform density hematoma, positive rate of hematoma mixed character, positive rate of hematoma black holes), rate of early neurologic deterioration, hematoma expansion rate, 3 weeks NIHSS score, mRS score in poor prognosis group were higher than those in good prognosis group, while the computed tomography (CT) for the first time and completion time is shorter than good prognosis group, baseline hematoma volume was larger than good prognosis group, the differences were statistically significant (all P < 0.05). Positive rate of non-uniform density hematoma and systolic blood pressure at admission were influencing factors of hematoma enlargement, early deterioration of neurological function and poor prognosis at 6 months in patients with cerebral hemorrhage at basal ganglia (P < 0.05). Conclusion CT non-uniform density hematoma (black hole sign or blend sign) is an risk factor for poor prognosis of spontaneous cerebral hemorrhage.