高血压性脑出血的CT特征与预后关系的Logistic分析

目的:探讨各型高血压性脑出血的CT特点与临床预后的关系。方法:回顾性分析270例高血压脑出血患者CT片,将其分为5型,观察性别、年龄、出血部位、出血量、出血是否破入脑室、中线结构移位情况,根据患者12个月后的Barthel指数评分(BI),将其分为良好、轻残、中残、重残/死亡四组,并依此作单因素和多因素的有序Logistic回归分析及生存分析,探讨各型的CT改变与一年后的预后情况相关性。结果:对预后影像因素的单因素有序logistic回归分析表明,基底节出血量≥50ml、皮质下出血≥30ml、小脑出血≥15ml、脑干出血≥5ml;血肿破入脑室;中线结构移位≥10mm与预后不良显著相关(OR分别为19.011、7.071、13.585),多因素有序logistic回归筛选出出血量、血肿破入脑室是影响患者预后不良的重要预测因素。结论:血肿体积、继发性脑室出血、中线结构移位可用于预测高血压脑出血预后的风险。

Multivariate analysis of CT features and long prognosis in patients of hypertensive cerebral hemorrhage

Objective To study the relationship between CT features and clinic prognosis of hypertensive cerebral hemorrhage patients.Methods Retrospective analyzed CT finding of 270 cases with HCH,which were divided into 5 types.Reviewing the data of the Barthel indexes of ADL on 12 months later,the patients were divided into 4 groups :good clinic prognosis,slight disability,moderate disability,severe disability/death.The single factor analysis and multiple factors analysis were done to find risk fctors as well as analyze the relationship between these factors and CT feature.Results Single factor logistic regression indicate that there was a significant relationship between clinic prognosis and following conditions: the hemorrhage volume,the hematoma breaked into cerebral ventricle and the shift of middle line structure.(OR =19.011、7.071、13.585).Multiple factors logistic regression analysis screened out such independent CT predictors as volume of hematoma(OR =29.607),the hematoma breaking into cerebral ventricle(OR=6.384)that would influence the prognosis of HCH.Conclusions The volume of hematoma and secondary ventricular hemorrhage,the shift of middle line structure can be used to predict death/disability rate of HCH.