扩大的血管周围间隙与脑出血患者神经功能恢复及生活质量的关系

目的 探讨扩大的血管周围间隙（enlarged perivascular space，ePVS）与脑出血患者神经功能恢复及生
活质量的关系。
方法 前瞻性连续纳入2014年8月-2017年11月广东同江医院神经内科住院治疗的急性脑出血患者，
根据颅脑MRI结果分为ePVS组及非ePVS组。记录其年龄、性别、入院时NIHSS评分等基线资料。发病
90 d时通过门诊随访，使用mRS评价患者神经功能恢复，对神经功能恢复不良（mRS评分＞2分）的可
能影响因素进行单因素和多因素分析；使用欧洲五维健康（European quality of life 5 dimensions with
5 l evel s，EQ-5D）量表评估患者生活质量，对生活质量低劣（EQ-5D评分≤0.5分）的可能影响因素进行
单因素和多因素分析。
结果 共纳入483例急性脑出血患者。ePVS组患者208例（43.1%），非ePVS组患者275例（56.9%）。
随访中死亡47例，其中ePVS组内有38例（18.27%）患者死亡，而非EPVS组有9例（3.27%）患者死亡，差
异有统计学意义（P＜0.001）。患者中有256例（53.00%）患者神经功能恢复不良，ePVS组154（74.04%）
例，非ePVS组102（37.09%）例，差异有统计学意义（P＜0.001）。有436例患者完成生活质量分析，生
活质量低劣者共202例（46.33%），ePVS组110例（64.71%）和非ePVS组92例组（34.59%），差异有
统计学意义（P＜0.001）。多因素分析显示ePVS是急性脑出血患者神经功能预后（OR 1.124，95%CI
1.033～1.223，P =0.006）、生活质量（OR 1.425，95%CI 1.115～1.820，P =0.005）的独立危险因素。
结论 ePVS是脑出血患者神经功能恢复不良及生活质量低劣的独立影响因素。ePVS组脑出血患者
90 d内死亡率较高。

Correlation between Enlarged Perivascular Space and the Prognosis of Patients with Cerebral Hemorrhage

Objective To investigate the correlation between enlarged perivascular space (ePVS) and the
prognosis of patients with cerebral hemorrhage.
Methods This prospective study consecutively enrolled patients with cerebral hemorrhage
admitted to Department of Neurology of Guangdong Tongjiang Hospital from 2014 August to 2017
November. The patients were divided into with ePVS group and no-ePVS group according to MRI
results. The baseline data were recorded. Neurological functional outcome at 90 days was assessed
using the mRS and quality of life using the European quality of life 5 dimensions with 5 levels (EQ-
5D). Poor functional outcome was defined as a mRS score of 3 to 6 at 90 days and poor quality of
life as an EQ-5D index score of 0.5 or less. Multivariate analysis was used to analyze the influence
factors for poor functional outcome and poor quality of life.
Results A total of 483 patients were included, with 208 (43.1%) cases in ePVS group and 275 (56.9%)
in no-ePVS group. The mortality between the two groups was statistically significant (P <0.001):38 (18.3%) in EPVS group versus 9 (3.27%) in no-ePVS group. 154 patients (74.04%) had poor
functional outcome in ePVS group, compared with 102 (37.09%) in no-ePVS group (P <0.001).
110 patients (64.71%) had poor quality of life in ePVS group, compared with 92 (34.59%) in noePVS
group (P <0.001). Multivariate analysis showed that ePVS was an independent risk factor for
neurological functional outcome (OR 1.124, 95%CI 1.033-1.223) and quality of life (OR 1.425,
95%CI 1.115-1.820) in patients with cerebral hemorrhage.
Conclusions ePVS was an independent risk factor for neurological functional outcome and quality
of life in patients with cerebral hemorrhage. ePVS was related to higher risk of death within 90
days after cerebral hemorrhage.