青年高血压脑出血111例预后的单中心临床研究

Prognosis of 111 young patients with hypertensive intracerebral hemorrhage:a single center clinical study

目的探讨不同年龄段、性别、出血部位的青年高血压脑出血患者预后的差异。方法回顾性分析2016年10月至2021年10月山东省第二人民院收治的青年高血压脑出血患者111例。根据年龄分为24~34岁组(47例)和35~45岁组(64例);根据性别分为男性组(60例)和女性组(51例);排除复合出血者(18例)后按出血部位分为基底节出血组(39例)、脑干出血组(26例)和脑室内出血组(28例)。比较不同年龄、性别以及出血部位的患者在治疗后1、3、12个月的格拉斯哥预后评分(GOS)、美国国立卫生院神经功能缺损评分(NIHSS)和远期卡氏功能状态(KPS)的差异。结果24~34岁组1、3个月的GOS、NIHSS和KPS评分与35~45岁组比较差异无统计学意义(P>0.05);24~34岁组12个月的GOS、NIHSS和KPS评分与35~45岁组显著提高(P<0.05)。男性组和女性组1、3、12个月GOS、NIHSS和KPS评分比较差异无统计学意义(P>0.05)。基底节出血组在1、3个月GOS、NIHSS和KPS评分优于脑干出血组和脑室内出血组,脑干出血组12个月GOS、NIHSS和KPS评分优于基底节出血组和脑室内出血组(P<0.05)。结论青年高血压脑出血患者的短期预后和年龄没有直接关系,长期预后年龄越小预后越好。青年高血压脑出血的预后和性别没有相关性。短期预后基底节区脑出血优于脑干出血且优于脑室内出血;长期预后脑干出血优于基底节出血和脑室内出血。

Objective To explore the differences in prognosis of young hypertensive intracerebral hemorrhage(HIH)patients with different age,gender,and bleeding sites.Methods A retrospective analysis of 111 young HIH patients admitted to Shandong Second Provincal General Hospital from October 2016 to October 2021 was conducted.The patients were divided into 24-34 age group(47 cases)and 35-45 age group(64 cases)according to age.The patients were divided into male group(60 cases)and female group(51 cases)according to gender.After excluding the compound hemorrhage(18 cases),patients were divided into basal ganglia hemorrhage group(39 cases),brainstem hemorrhage group(26 cases),and intraventricular hemorrhage group(28 cases)according to the location of bleeding.Glasgow Outcome Scale(GOS),National Institutes of Health Neurological Deficit Scale(NIHSS),and long-term Karnofsky Performance Status(KPS)were compared among patients in different age groups,gender groups,and bleeding site groups at 1,3,and 12 months after treatment.Results There was no significant difference in scores of GOS,NIHSS and KPS at 1 and 3 months between 24-34 age group and 35-45 age group(P>0.05).The 12-month GOS,NIHSS and KPS scores of the 24-34 age group were significantly higher than those of the 35-45 age group(P<0.05).There was no significant difference in GOS,NIHSS and KPS scores between male group and female group at 1,3 and 12 months(P>0.05).The scores of GOS,NIHSS and KPS in basal ganglia hemorrhage group were better than those in brainstem hemorrhage group and intraventricular hemorrhage group at 1 and 3 months,and the scores of GOS,NIHSS and KPS in brainstem hemorrhage group were better than those in basal ganglia hemorrhage group and intraventricular hemorrhage group at 12 months(P<0.05).Conclusion The short-term prognosis of young patients with HIH is not directly related to age.But for the long-term prognosis,the younger the better.There is no correlation between the prognosis and gender in HIH in young people.The short-term prognosis of basal ganglia cerebral hemorrhage is better than brainstem hemorrhage and intraventricular hemorrhage.The long-term prognosis of brain stem hemorrhage is better than basal ganglia hemorrhage and intraventricular hemorrhage.