脑静脉/静脉窦血栓形成合并脑出血的症状特点及危险因素分析

Symptom characteristics and risk factors logistic regression analysis of CVST combined with cerebral hemorrhage

目的探讨脑静脉/静脉窦血栓形成(cerebral venous sinus thrombosis,CVST)合并脑出血的症状特点,并应用logistic回归分析法分析其危险因素。方法回顾性分析2016年8月至2019年8月河南省人民医院收治的120例CVST患者的临床资料,根据是否合并脑出血将其分为出血组和未出血组。比较两组患者的症状特点,并采用单因素及多因素logistic回归分析明确CVST合并脑出血的相关危险因素。结果CVST患者中52例合并脑出血,出血组患者视力下降、癫痫、失语、意识障碍、运动障碍患者构成比显著高于未出血组(P<0.05),出血组患者头痛、感觉障碍构成比与未出血组比较差异无显著性(P>0.05);出血组和未出血组性别、高胆固醇血症、高三酰甘油血症、高血压、体重指数、遗传性易栓症、感染性疾病、血液系统疾病、上矢状窦受累、下矢状窦受累、横窦受累患者的构成比差异无显著性(P>0.05),出血组年龄>35岁、病程<24h或>30h、直窦受累患者及处于妊娠期/围生期的女性患者构成比均显著高于未出血组(P<0.05),且经logistic回归分析证实这些因素均是CVST合并脑出血的独立危险因素(P<0.05)。结论CVST合并脑出血患者易发生视力下降、癫痫、失语、意识障碍、运动障碍,且年龄>35岁、病程<24h或>30h、直窦受累、妊娠期/围生期的CVST患者更易发生脑出血。

Objective To explore the symptom characteristics of cerebral venous sinus thrombosis(CVST)combined with cerebral hemorrhage and analyze its risk factors by logistic regression analysis.Method The data of 120 patients with CVST were retrospectively analyzed from January 2016 to January 2018 in our hospital.According to whether combined with intracerebral hemorrhage,they were divided into hemorrhage group and non-hemorrhagic group.The symptom characteristics of the two groups were compared,and the risk factors of CVST combined with cerebral hemorrhage were determined by single factor and multivariate logistic linear regression analysis.Result There were 52 cases of cerebral hemorrhage in the patients with CVST.The rates of visual loss,epilepsy,aphasia,disturbance of consciousness and dyskinesia in the hemorrhage group were significantly higher than those in the non-hemorrhagic group(P<0.05),while there were no differences in the rates of headache and sensory disturbance of the two groups(P>0.05).There were no differences in the rates of gender,hypercholesterolemia,hypertriglyceridemia,hypertension,BMI,genetic prethrombus,infectious disease,blood system disease,the involvement of superior sagittal sinus,inferior sagittal sinus and transverse sinus of the patients between the hemorrhage group and the non-hemorrhagic group(P>0.05),while the rates of age more than 35,duration of disease was shorter than 24 h or longer than 30 h,straight sinus involvement,women in pregnancy/perinatal period of the hemorrhage group were significantly higher than those of the nonhemorrhagic group(P<0.05),which were the independent risk factors of CVST combined with cerebral hemorrhage by logistic regression analysis(P<0.05).Conclusion Patients with CVST combined with cerebral hemorrhage were prone to decrease vision,epilepsy,aphasia,disturbance of consciousness and dyskinesia,and CVST patients with age more than 35,course of disease shorter than 24 h or longer than 30 h,straight sinus involvement and pregnancy/perinatal period were more likely to have cerebral hemorrhage.