Influence of Hypertension, Lipometabolism Disorders,Obesity and Other Lifestyles on SpontaneousIntracerebral Hemorrhage

Objective To investigate whether hypertension, abnormal lipometabolism, obesity, cigarette smoking and alcohol drinking affect the intracerebral hemorrhagic volumes (IHV) in patients with spontaneous intracerebral hemorrhage (SIHP), and to explore the roles of these factors in spontaneous intracerebral hemorrhage (SIH). Methods Five hundred patients with acute SIH and 200 healthy adult volunteers (HAV) were enrolled in a study of independently randomized controlled design, in which the levels of systolic pressure (SP) and diastolic pressure (DP), and total cholesterol (TCH), triacylglycerols (triglycerides, TG), high density lipoprotein cholesterol (HDL-CH), low density lipoprotein cholesterol (LDL-CH) in serum as well as the level of erythrocytic membrane cholesterol (EM-CH) were measured, and the body mass index (BMI), daily cigarette smoking consumption (DCSC) and daily pure alcohol consumption (DPAC) were calculated. Results Compared with the average parameters in the HAV group, those of SP, DP, TG, LDL-CH and BMI in the SIHP group were significantly increased (P<0.0001), while those of HDL-CH and EM-CH were significantly decreased (P<0.0001). The linear regression and correlation analysis showed that with increased SP, DP, LDL-CH, BMI, DCSC, DPAC and aging as well as decreased HDL-CH and EM-CH, the IHV levels in SIHP were increased gradually (P<0.0001-0.01). The linear stepwise regression analysis suggested that there existed a close correlation among the values of SP, DP, TCH, TG, HDL-CH, LDL-CH, EM-CH, BMI, DCSC, DPAC, age and fflV of the SIH patients, and that Y = - 12.4583 + 0.1127SP -1.1977EM-CH + 0.9788LDL-CH + 0.2477BMI + 0.0382DCSC + 0.0248DP,P<0.0001-0.05. Conclusions The findings in the present study suggest that significantly increased systolic and diastolic pressure, low density lipoprotein cholesterol, body mass index and daily cigarette smoking consumption, and significantly decreased erythrocytic membrane cholesterol may be likely the main factors affecting intracerebral hemorrhagic volumes in patients with acute spontaneous intracerebral hemorrhage.

Intra-abdominal hemorrhage during pregnancy: Four case reports

BACKGROUND Intra-abdominal hemorrhage during pregnancy is a rare and dangerous complication of pregnancy.In this article,we report 4 cases of intra-abdominal hemorrhage during pregnancy,including the spontaneous rupture of uterine veins,spontaneous rupture of liver,rupture of external iliac vessel branch,and rupture of right renal hamartoma.CASE SUMMARY The clinical manifestations of three patients lacked specificity,and the localization of the bleeding was not clear prior to surgery.All 4 pregnant women were successfully treated,while only one full-term infant survived.CONCLUSION There are diverse causes of intra-abdominal hemorrhage during pregnancy in clinic,and it is clinically characterized by acute abdominal pain during pregnancy.Clear diagnosis before surgery is rather difficult.Early diagnosis,timely and appropriate treatment and surgery,and multidisciplinary cooperation are key to saving pregnant females’lives and improving the outcomes of perinatal infants.

Astrocytes in the cerebral cortex play a role in the spontaneous motor recovery following experimental striatal hemorrhage

Intracerebral hemorrhage （ICH） is a stroke subtype caused by spontaneous rupture of small vessels and bleeding into the brain paren- chyma, resulting in cell death and sensorimotor deficits. Despite the greater prevalence of the ischemic form of stroke （87%）, ICH has the highest mortality rate of all stroke subtypes. The striatum is the most affected structure in hemorrhagic stroke （35-70%）, followed by cere- bral cortex （15-30%）, brain stem and cerebellum （5-10%）; patients suffering striatal and/or cortical ICH bear persistent sensorimotor disabilities. Although chronic sensorimotor impairment is established, a considerable amount of patients experience some degree of spontaneous recovery during the first six months after stroke （Qureshi et al., 2009）, and the neurobiological basis of this process is not understood.

Multifocal Spontaneous Intracerebral Hemorrhage about a Case and Review of the Literature

We describe the case of a spontaneous multifocal intracerebral hemorrhage in a Congolese subject presenting no risk factor. He is a 32-year-old subject with no particular history admitted for seizures in which the cerebral scanner has revealed spontaneous multifocal intracerebral hemorrhages. He only received medical treatment. It remains a very rare entity. The location of the hematoma is variable and is usually located in the basal ganglia due to chronic hypertension.

Injectable collagen scaffold with human umbilical cordderived mesenchymal stem cells promotes functional recovery in patients with spontaneous intracerebral hemorrhage:phase Ⅰ clinical trial

Animal expe riments have shown that injectable collagen scaffold with human umbilical cord-derived mesenchymal stem cells can promote recovery from spinal cord injury.To investigate whether injectable collagen scaffold with human umbilical cord-derived mesenchymal stem cells can be used to treat spontaneous intracerebral hemorrhage,this non-randomized phase I clinical trial recruited patients who met the inclusion criteria and did not meet the exclusion crite ria of spontaneous intracerebral hemorrhage treated in the Characteristic Medical Center of Chinese People’s Armed Police Force from May 2016 to December 2020.Patients were divided into three groups according to the clinical situation and patient benefit:control(n=18),human umbilical cord-derived mesenchymal stem cells(n=4),and combination(n=8).The control group did not receive any transplantation.The human umbilical cord-derived mesenchymal stem cells group received human umbilical cord-derived mesenchymal stem cell transplantation.The combination group received injectable collagen scaffold with human umbilical cord-derived mesenchymal stem cells.Patients who received injectable collagen scaffold with human umbilical cord-derived mesenchymal stem cells had more remarkable improvements in activities of daily living and cognitive function and smaller foci of intra cerebral hemorrhage-related encephalomalacia.Severe adve rse events associated with cell transplantation were not observed.Injectable collagen scaffold with human umbilical cord-derived mesenchymal stem cells appears to have great potential treating spontaneous intracerebral hemorrhage.

Pancreatic cavernous hemangioma complicated with chronic intracapsular spontaneous hemorrhage:A case report and review of literature

BACKGROUND Pancreatic cavernous hemangioma(pCH)is a rare type of benign vascular tumor.Making the right diagnosis is challenging due to low clinical suspicion and the lack of existing cross-sectional imaging tools to distinguish it from other pancreatic lesions.CASE SUMMARY We describe a male patient,age 18,who presented with a pCH.Computed tomography,magnetic resonance imaging,and ultrasound showed cystic space in the tail of the pancreas.A dark spot sign on the T2 weighted image sequence was observed.Clinically,a mucinous cystic neoplasm with hemorrhage was suspected preoperatively by combining imaging,and the operative indication was clear.The patient underwent a distal pancreatic tumor resection under laparoscopic control.Immunohistochemical staining for CD31 and CD34 was positive;D2-40 was positive in interstitial lymphatic vessels and negative in vascular epithelial cells;and calcium-binding protein was negative.The results support the diagnosis of pCH combined with chronic intracapsular spontaneous hemorrhage.No complications or recurrences were observed during the follow-up period.CONCLUSION Chronic spontaneous hemorrhage may occur in pCH,which may greatly influence the accuracy of diagnosis using imaging modalities.Surgical resection for uncertain pCH seems reasonable with a good outcome.

Elevated soluble fas blood concentrations in patients dying from spontaneous intracerebral hemorrhage

BACKGROUND Several studies of spontaneous intracerebral hemorrhage(SICH)patients have shown apoptotic changes in brain samples after hematoma evacuation.However,there have been no data on the association between blood concentrations of soluble fas(sFas)(the main surface death receptor of the extrinsic apoptosis pathway)and the prognosis of spontaneous intracranial hypotension(SIH)patients.AIM To determine whether there is an association between blood sFas concentrations and SICH patient mortality.METHODS We included patients with severe and supratentorial SIH.Severe was defined as having Glasgow Coma Scale<9.We determined serum sFas concentrations at the time of severe SICH diagnosis.RESULTS We found that non-surviving patients(n=36)compared to surviving patients(n=39)had higher ICH score(P=0.001),higher midline shift(P=0.004),higher serum sFas concentrations(P<0.001),and lower rate of early hematoma evacuation(P=0.04).Multiple logistic regression analysis showed an association between serum sFas concentrations and 30-d mortality(odds ratio=1.070;95%confidence interval=1.014-1.129;P=0.01)controlling for ICH score,midline shift,and early hematoma evacuation.CONCLUSION The association of blood sFas concentrations and SICH patient mortality is a novel finding in our study.

The value of three-dimensional computed tomographic angiography in the early diagnosis and treatment of spontaneous subarachnoid hemorrhage (616 cases report)

Objective To evaluate the clinical value of three dimensional computerized tomography angiography in the diagnosis and treatment of spontaneous subarachnoid hemorrhage. Methods 616 cases were diagnosed as suspected intracranial aneurysms in 3D CTA system. Computed tomographic scans and CTA studies were

Acquired factor XIII deficiency presenting with multiple intracranial hemorrhages and right hip hematoma:A case report

BACKGROUND Factor XIII(FXIII)deficiency is a rare yet profound coagulopathy.FXIII plays a pivotal role in hemostasis,and deficiencies in this factor can precipitate unchecked or spontaneous hemorrhaging.Immunological assays for detecting FXIII inhibitors are indispensable for diagnosing acquired FXIII deficiency;however,the availability of suitable testing facilities is limited,resulting in prolonged turnaround times for these assays.CASE SUMMARY In this case study,a 53-year-old male devoid of significant medical history presented with recurrent intracranial hemorrhages and a hematoma in the right hip.Subsequent genetic analysis revealed a homozygous mutation in the ACE gene,confirming the diagnosis of acquired FXIII deficiency.CONCLUSION This case underscores the significance of considering acquired deficiencies in clotting factors when evaluating patients with unexplained bleeding episodes.

Clinical feature and predictive factor analysis for spontaneous regression of retinopathy of prematurity in a Chinese population

AIM:To investigate the ratio of spontaneous regression of retinopathy of prematurity(ROP)and to explore the possible relevant predictive factors.METHODS:A retrospective review of 405 infants who were diagnosed with ROP and mother during pregnancy were collected.Stage,zone,and duration of ROP were recorded.Statistical analysis was performed on 51 possible predictive factors.RESULTS:Totally 356 infants showed spontaneous regression.The incidence was 100%,95.3%,and 22.7%in stage 1,2,and 3,respectively.The 13.4%of the ROP with plus disease eventually resolved spontaneously.All affected eyes of aggressive posterior retinopathy of prematurity(APROP)failed to spontaneously regress.The mean duration of ROP was 7.2wk in patients with spontaneous resolution of ROP.Days of mechanical ventilation(OR=0.981,95%CI,0.965-0.997,P=0.021),retinal hemorrhage(OR=0.173,95%CI,0.064-0.470,P=0.001),delivery pattern(OR=2.750,95%CI,1.132-6.681,P=0.025),maternal anemia in pregnancy(OR=0.142,95%CI,0.036-0.563,P=0.005),the stages(at initial diagnosis OR=0.183,95%CI,0.041-0.816,P=0.026;at final diagnosis OR=0.031,95%CI,0.006-0.167,P<0.001),and with plus disease or not(OR=0.005,95%CI,0.001-0.031,P<0.001)were independent predictive factors of the spontaneous regression of ROP.CONCLUSION:Most mild ROP can spontaneously resolve.Active treatment is still recommended for stage 3 ROP,zone I ROP,AP-ROP,and ROP with plus disease.Prolonged mechanical ventilation and concurrent retinal hemorrhage reduce the likelihood of spontaneous ROP resolution.The pattern of delivery and the mother's anemia during pregnancy can also affect the prognosis of ROP.

Bulbar conjunctival vascular lesion combined with spontaneous retrobulbar hematoma:A case report

BACKGROUND Orbital hemorrhage can be classified as traumatic or spontaneous depending on its cause.Spontaneous orbital hemorrhage refers to an internal orbital hemorrhage without apparent cause.Therefore,we aimed to describe a case of an orbital hematoma after a severe cough the night before due to inhalation of cooking oil fumes.CASE SUMMARY A 46-year-old woman was referred to our hospital with a complaint of exophthalmos accompanied with blurred vision,pain,binocular diplopia,and dizziness lasting for 5 h noted on waking in the morning.She also experienced nausea and vomiting due to high pressure of orbit and dizziness.Based on the auxiliary examination and her medical history,the patient was finally diagnosed with bulbar conjunctival vascular lesion combined with spontaneous retrobulbar hematoma.The patient was administered tobramycin and dexamethasone eye ointment,and applied pressure dressing on the left eye to stop the bleeding.Simultaneously,we administered intravenous etamsylate,oral Yunnan Baiyao capsule,intravenous mannitol to reduce orbital pressure,and intravenous dexamethasone injection at 10 mg/dL combined with neurotrophic therapy to reduce tissue edema.Among them,the Yunnan Baiyao capsule is a traditional Chinese herbal medicine to remove stasis and stop bleeding;thus,it promotes blood circulation and relieves pain resulting in reduced edema of the lesion site.The symptoms did not improve significantly during the first 2 d of treatment.We speculate that high orbital pressure and binocular diplopia induced frequent nausea and vomiting in the patient,causing increased pressure on the superior vena cava and leading to repeated orbital bleeding.After the second day,the symptoms started gradually improving.CONCLUSION This case further emphasizes the importance of comprehensive,detailed medical history and careful ophthalmic examination of the patient.

Spontaneous Disappearance of a Ruptured Intracranial Aneurysm

The spontaneous disappearance of a ruptured intracranial aneurysm is unusual and its mechanism remains incompletely understood. However, several hypotheses are put forward and are mostly found in Virchow’s triad. We report the case of a man who suffered subarachnoid hemorrhage by rupture of a blister aneurysm of the P1 segment of the left posterior cerebral artery. A control arteriography performed one week after the rupture showed a disappearance of the aneurysm and a significant vasospasm of the carrier artery. Angiograms performed at 3 weeks and 3 months confirmed this disappearance of the aneurysm and a return to normal artery size. Clinically the patient was doing well. Therefore his aneurysm was spontaneously declared cured. Several studies are needed to clarify the natural history of spontaneously thrombosed aneurysms and elucidate their occurrence mechanism in order to improve the management of intracranial aneurysmal pathology.

Establishment of a rat model of severe spontaneous intracerebral hemorrhage

Background:Severe intracerebral hemorrhage(ICH)is the most devastating subtype of stroke resulting in high mortality and disability.At present,the development of targeted treatments to minimize the high morbidity and mortality is limited partly due to the lack of a severe ICH animal model.In this study,we aimed to establish an accurate severe ICH model in rats and examine the pathological and physiological changes associated with ICH.Methods:A rat model of severe ICH model was established by intrastriatal injection of autologous blood using different blood volumes(ICH 100μL group,ICH 130μL group,ICH 160μL group,ICH 170μL group,and ICH 180μL group).The mortality was assessed during the 28-day post-ICH period.Short-and long-term neurological deficits were evaluated using the Longa method,foot fault,falling latency,and Morris water maze tests.Brain water content,hematoma volume,hemoglobin content,and magnetic resonance imaging were assessed to determine the extent of brain injury.Immunofluorescence staining was conducted to examine microglial activation and neuronal apoptosis.Hematoxylin and eosin(H&E)staining,lung water content,and western blotting were used to assess lung injury following ICH.Results:The mortality of ICH rats increased significantly with an increase in autologous blood injection.The 28-day mortality in the 100μL,130μL,160μL,170μL,and 180μL ICH groups were 5%,20%,40%,75%,and 100%,respectively.A significantly higher 28-day mortality was observed in the ICH 160μL group compared to the ICH 100μL group.The ICH 160μL group exhibited significantly increased neurological deficits,brain edema,hematoma volume,and hemoglobin content compared to the sham group.Compared with the sham operation group,the activation of microglia and neuronal death in ICH 160μL rats increased.The use of H&E staining and western blotting demonstrated that disruption of the intra-alveolar structure,alveolar edema,and infiltration of inflammatory cells and cytokines into the lung tissue were more severe in the ICH 160μL group than the sham group.Conclusions:A severe ICH model in rats was successfully established using an injection of autologous blood at a volume of 160μL.This model may provide a valuable tool to examine the pathological mechanisms and potential therapeutic interventions of severe ICH.

Massive, Spontaneous Facial Hematoma in a Neurofibromatosis Type 1 Patient

Significant hemorrhage in Neurofibromatosis Type 1 (NF-1) patients occurs infrequently, but has potentially devastateing consequences when occurring in the head and neck region. There have been no prior reports of patients with hemodynamically significant, rapidly-expanding lesions into a neurofibroma in the head and neck region without preceding trauma. This case describes the management of a spontaneous, rapidly expanding facial hematoma in an NF-1 patient with an extensive facial and skull base plexiform neurofibroma. The patient underwent angioembolization of his left external carotid artery prior to operative management. The strategies utilized can be extended to management of facial hematomas arising from more common situations such as fractures, lacerations, and pseudoaneursyms, along with bleeding from subacute conditions like other head and neck cancers.

Stereotactic aspiration and thrombolysis of spontaneous intracerebellar hemorrhage

Background Spontaneous intracerebellar hemorrhage （SCH） accounts for 10% of intracerebral hemorrhages. Up to now stereotactic aspiration and thrombolysis of SCH was less reported. The aim of this study was to assess the effect and feasibility of the method, and to refine the clinical protocol. Methods Eighteen patients with SCH were treated by stereotactic aspiration and thrombolysis and reviewed in this report. The 3-ram axial stereotactic computed tomoaraDhv slices throughout the hematoma were obtained.

Spontaneous retroperitoneal hemorrhage after hemodialysis involving anticoagulant agents

In this paper, we described the symptoms and treatment of a patient with diabetic nephropathy accom- panied by spontaneous retroperitoneal hemorrhage after hemodialysis. An elderly female patient with diabetic neph- ropathy presented with severe pain, numbness, and an increasing swelling in the left hip and left thigh after six ses- sions of hemodialysis involving the use of an antiplatelet drug and an anticoagulant agent. Her hemoglobin decreased to 46 g/L. An abdominal ultrasound showed a hematoma in the left retroperitoneal space, and computed tomography (CT) findings revealed a 6 cm×8 cm×10 cm hematoma in the left psoas muscle. After aggressive supportive therapy [the administration of packed red blood cell transfusion, carbazochrome sodium sulfonate injection, and continuous venovenous hemofiltration (CVVH)], the patient's vital signs stabilized and her hemoglobin increased to 86 g/L. Repeat CT showed that the hematoma had been partially absorbed after two weeks. Eventually, the patient was discharged with stable vital signs. Physicians should be aware of the possibility of spontaneous retroperitoneal hemorrhage, particularly in patients with diabetic nephropathy undergoing hemodialysis involving the use of anticoagulant agents.

Spontaneous Subdural Hemorrhage due to Ruptured Arteriovenous Malformation in a Child

Spontaneous subdural hemorrhage(SDH)is an uncommon nontraumatic bleed of the brain,involving the dura and arachnoid mater.SDH commonly occurs due to tearing of bridging veins;however,SDH from the rupture of arteriovenous malformation(AVM)is an uncommon phenomenon,particularly in children.We report a case of atypical SDH in a 1-year-old child with AVM and a history of alleged abuse.Autopsy revealed SDH in the right parietal and middle cranial fossa without any external or internal injuries to the head,brain,or other parts of the body.Histopathological examination and immunohistochemical staining of the brain tissue revealed an abnormal distribution of arteries and veins of various sizes and architecture.From a detailed histopathological examination of the brain and meticulous investigation of vascular abnormalities,we conclude the cause of acute SDH to be due to a ruptured AVM.

自发性脑出血患者CT征象预测血肿增大的临床价值

目的探究自发性脑出血(sICH)患者CT征象预测血肿增大的临床价值。方法选取我院2020年6月到2023年6月收治的91例sICH患者作为研究对象,患者入院后均行CT平扫及血管成像检查(CTA),分析不同CT征象预测血肿增大的效能。结果91例sICH患者中,发生血肿增大43例(47.25%),未发生血肿增大48例(52.75%);CT平扫出现黑洞征41例(45.05%),混合征50例(54.95%);岛征39例(42.86%);渗漏征33例(48.35%);斑点征45例(49.45%)。CT平扫中黑洞征预测血肿增大的敏感度、特异度分别为51.16%、60.42%;混合征为79.07%、66.67%;岛征为67.44%、79.17%;三者联合为48.84%、89.58%。CTA征象中渗漏征预测血肿增大的敏感度、特异度分别为76.74%、77.08%;斑点征为83.72%、81.25%;二者联合为74.42%、91.67%,其特异度最高。结论CT平扫与CTA征象均可有效预测sICH患者血肿增大,其中CTA斑点征与渗漏征联合预测临床价值最高。

Preventive Effect of Perioperative Management Using Oral Clopidogrel on Postoperative Rebleeding in Patients with Spontaneous Intracerebral Hemorrhage

Background: With the aging society in China and the increasing incidence of cardiovascular and cerebrovascular diseases,spontaneous cerebral hemorrhage with the use of oral clopidogrel has become common in patients. Owing to its inhibition of platelet aggregation,oral clopidogrel results in a high incidence of postoperative intracranial rebleeding,and the prognosis is poor. The purpose of this study is to determine the effect of perioperative management of spontaneous intracerebral hemorrhage (SICH) using oral clopidogrel on postoperative rebleeding. Methods: From January 2010 to June 2018,64 patients with SICH who took clopidogrel orally and finally received surgical treatment were selected from Huzhou First People’s Hospital and the Second Affiliated Hospital of Wenzhou Medical University. The influencing factors of postoperative rebleeding were analyzed via a case-control study. Results: All patients with SICH were divided into two groups according to the standard time of drug withdrawal before surgery: drug withdrawal at < 3 days and ≥ 3 days. The incidence of postoperative rebleeding after drug withdrawal at ≥ 3 days was significantly lower than that after drug withdrawal at < 3 days. Thereafter,all patients were divided into two groups according to the adenosine diphosphate (ADP) inhibition rate detected using a thromboelastography monitor: ADP inhibition rate of < 60% and ≥ 60%. The incidence of postoperative rebleeding in the ADP inhibition rate of < 60% group was significantly lower than that in the ADP inhibition rate of ≥ 60% group. In addition,drug withdrawal at ≥ 3 days and ADP inhibition rate of < 60% had a synergistic effect on the prevention of postoperative rebleeding. Conclusions: Patients with drug withdrawal at ≥ 3 days can undergo active early surgery. The ADP inhibition rate of ≥ 60% can be used as the predictive index of high-risk postoperative rebleeding in patients with SICH taking oral clopidogrel. By reducing the ADP inhibition rate to < 60%,the incidence of postoperative rebleeding can also be reduced.

ICU自发性脑出血患者再出血的风险预测列线图模型构建

目的探讨重症监护室(ICU)自发性脑出血患者再出血的影响因素,并依此建立列线图预测模型。方法回顾性分析2019年6月至2022年6月无锡市第二人民医院收治的173例ICU自发性脑出血患者的临床资料,根据患者有无再出血将其分为再出血组(38例)和未再出血组(135例)。比较两组患者一般资料,采用多因素logistic回归分析法分析ICU自发性脑出血患者再出血的影响因素,并采用R3.4.3软件包绘制列线图模型,另绘制受试者操作特征曲线(ROC)以评估列线图模型的预测效能,绘制校准曲线图评估列线图的区分度,采用Bootstrap法检验预测列线图模型的一致性。采用t检验、χ^(2)检验。结果再出血组男24例、女14例,年龄(61.57±7.53)岁;未再出血组男75例、女60例,年龄(59.08±7.39)岁。两组患者性别、年龄、体质量指数(BMI)、吸烟史、饮酒史、糖尿病史、病因分型、格拉斯哥昏迷量表(GCS)评分、血肿形状、血肿位置、出血量、手术方式、术前收缩压、术前舒张压、术前血小板计数、术后使用止血药比较,差异均无统计学意义(均P>0.05);再出血组长期使用抗凝药、血肿密度不均匀、手术时机3~6 h、术后血压控制不理想、术后躁动占比及术前血糖、术前D-二聚体水平均高于未再出血组[47.37%(18/38)比24.44%(33/135)、71.05%(27/38)比43.70%(59/135)、31.58%(12/38)比10.37%(14/135)、18.42%(7/38)比2.96%(4/135)、42.11%(16/38)比22.96%(31/135)、(6.39±1.02)mmol/L比(5.95±1.25)mmol/L、(0.51±0.04)mg/L比(0.43±0.05)mg/L],差异均有统计学意义(χ^(2)=7.496、8.872、10.476、12.924、5.491,t=1.990、9.073;均P<0.05)。多因素logistic回归分析显示,长期使用抗凝药、血肿密度不均匀、手术时机为3~6 h、术前D-二聚体水平升高、术后血压控制不理想、术后躁动均是ICU自发性脑出血患者再出血的危险因素(均P<0.05)。ROC分析结果显示,列线图预测ICU自发性脑出血患者再出血的曲线下面积(AUC)为0.848(95%CI 0.799~0.887),灵敏度为76.32%,特异度为84.44%。经Bootstrap法对模型进行验证,其一致性指数(C-index)为0.829,校正曲线与标准曲线贴合度较好。结论长期使用抗凝药、血肿密度不均匀、手术时机为3~6 h、术前D-二聚体水平升高、术后血压控制不理想、术后躁动均是ICU自发性脑出血患者再出血的危险因素,基于以上影响因素构建的列线图模型具有较好的预测效能,有利于临床早期筛选ICU自发性脑出血患者再出血。