自发性脑出血住院患者发病时间变化的规律分析

目的探讨自发性脑出血患者发病时间变化的规律性.方法采用回顾性调查方法对脑出血发病进行昼夜时间和月变化的规律分析.将24 h分为12个时段,按1年12个月份进行分析.结果(1)一昼夜各发病时间段之间脑出血发病人数有显著性差异(X2=63.799,P＜0.001),呈双峰分布,7～8 am、5～6pm为2个发病高峰,午后1～2 pm为发病低谷;不同月份间脑出血发病人数有显著性差异(r=0.732,P＜0.05),呈冬季高夏季低分布;(2)男、女脑出血12时段内发病人数均有显著性差异(男X2=39.310,P＜0.001,女X2= 68.369,P＜0.001);男女脑出血月份间发病人数均有显著性差异(男r=0.627,P＜0.05,女r=0.966,P＜0.05).结论脑出血发病与昼夜时间有关,呈双峰分布;脑出血发病与月份气候变化有关,有冬季发病的集中趋势.     

复发性脑出血临床特点和危险因素分析

目的　探讨复发性脑出血的临床特点和相关危险因素。方法　回顾性分析 5 6例复发性脑出血患者临床资料 ,并与同期住院的首发脑出血患者进行比较。结果　 5 6例患者共有 6 4次复发 ,复发间隔时间为 3.7±3.5年 ,34.4 %在 1年以内复发。复发类型以基底节 基底节最多见 ,其次为基底节 丘脑和基底节 脑叶 ,多在对侧复发 ,很少在同一部位复发。与首发患者相比 ,复发性脑出血患者多有高血压病 ,病程较长且控制不良。多变量Logistic分析显示高血压病程与复发脑出血正相关 ,首次发病年龄与复发脑出血负相关。结论　脑出血后 3年以内复发危险性较大 ,积极控制高血压有助于防止脑出血复发。     

CYP2C8 and CYP2J2 gene variations increase the risk of hypertensive intracerebral hemorrhage

PurposeMany studies have shown that cytochrome P450 (CYP) gene polymorphisms are usually associated with an increased risk of cardiovascular and cerebrovascular diseases. To explore the association of CYP2C8 and CYP2J2 gene polymorphisms with hypertensive intracerebral hemorrhage (HICH) in the Han Chinese population.MethodsForty HICH patients and 40 control subjects were recruited for this study. Two single nucleotide polymorphisms (SNP) (rs1058932, rs2275622) in the CYP2C8 gene and two SNPs (rs2271800, rs1155002) in the CYP2J2 gene were selected for genotyping by direct sequencing. Statistical analysis was applied to examine the effect of genetic variation on HICH.ResultsWe found that variant alleles of CYP2C8 rs1058932 (A) and rs2275622 (C) were both significantly associated with HICH, especially in females. We also found significant associations of CYP2C8 rs1058932 (A) and rs2275622 (C) variant alleles with poor outcomes in HICH patients, especially in males.ConclusionsCYP2C8 gene polymorphisms might increase the risk of HICH in the Han Chinese population and might lead to poor outcomes. This finding adds to the body of literature supporting novel therapeutic strategies for HICH.     

青年脑出血的病因及危险因素分析

目的探讨青年脑出血的危险因素及病因。方法回顾分析我院2008-01—2014-01收治的青年脑出血患者的临床资料。结果青年脑出血共779例,男性多于女性。病因从高到底依次为高血压、不明原因、血管畸形、妊娠/产褥期、瘤卒中、血液系统疾病、烟雾病和系统性红斑狼疮。危险因素为高血压、血脂异常、饮酒、心脑血管病家族史、吸烟、糖尿病和既往卒中史。18~31年龄组与32~45年龄组比,脑血管畸形发病比例明显增高(P0.05)。32~45年龄组与18~31年龄组比较,高血压脑出血比例明显增高(P0.05)。结论年龄增长脑出血比例增加,男性多于女性;高血压是主要病因,其次是脑血管畸形;高血压史、吸烟饮酒、血脂异常可能与青年脑出血有关。     

Hypertension as a risk factor for spontaneous intracerebral hemorrhage

To better define the etiologic importance of hypertension for spontaneous intracerebral hemorrhage, hospital records were studied for all patients sustaining intracerebral hemorrhage during 1982 in the Cincinnati metropolitan area. Hypertension pre-dating the hemorrhage was present in 45% (69 of 154), as determined by history. A more inclusive definition of hypertension, combining those with a positive history with those found to have left ventricular hypertrophy by electrocardiogram or cardiomegaly by chest radiography, applied in 56% (87 of 154). The cases were compared to controls with and without hypertension derived from the NHANES II study of blood pressure (n = 16,204) to determine relative risk. For the presence of hypertension by history, the relative risk of intracerebral hemorrhage was 3.9 (95% confidence interval, 2.7 to 5.7). For the inclusive definition of hypertension, the relative risk was 5.4 (3.7 to 7.9). Relative risk was also determined for hypertension in blacks (= 4.4), age greater than 70 (= 7), prior cerebral infarction (= 22), and diabetes (= 3). We conclude that the term "hypertensive hemorrhage" should be used very selectively, particularly in whites, and propose that hypertension be viewed as one of several important risk factors for spontaneous intracerebral hemorrhage.     

Optimization of risk stratification for anticoagulation-associated intracerebral hemorrhage: net risk estimation

Journal of Neurology - Every anticoagulation decision has in inherent risk of hemorrhage; intracerebral hemorrhage (ICH) is the most devastating hemorrhagic complication. We examined whether...     

Hypercholesterolemia as one of the risk factors of intracerebral hemorrhage

Stroke is still a major cause of morbidity and mortality throughout the world, although better stratification and treatment modalities are being developed. As compared to ischemic stroke, intracerebral hemorrhage (ICH) possesses many unknown data and lacks guidelines for better prophylaxis. In this study, we aimed to investigate patients with ICH hospitalized in our neurology department within 5 years in terms of risk stratification. A total of 4,449 patients were hospitalized; 1,378 of patients (31 %) were diagnosed as having cerebrovascular disease and of these 165 patients (3.7 %) had ICH. The risk factors of patients with ICH were investigated and compared with age- and gender matched 75 healthy subjects. We observed that hypercholesterolemia (p = 0.002) was one of the most common risk factors in patients with ICH as compared to controls, together with hypertension (p = 0.010). On the other hand, hypolipidemia (LDL-cholesterol level < 50 mg/dl) was not present in any of the patients. As our purpose as neurologists is to reduce the occurrence and fatal outcome of cerebrovascular events, we aimed to emphasize the importance of risk factors to be well defined, for which every effort should be exhibited for both primary and secondary prevention.     

Oligodendrocytes in intracerebral hemorrhage

Intracerebral hemorrhage (ICH) is a cerebrovascular disorder with high mortality and disability rates. Although a lot of effort has been put in ICH, there is still no effective treatment for this devastating disease. Recent studies suggest that oligodendrocytes play an important role in brain repair after ICH and thus may be targeted for the therapies of ICH. Here in this review, we first introduce the origin, migration, proliferation, differentiation, and myelination of oligodendrocytes under physiological condition. Second, recent findings on how ICH affects oligodendrocyte biology and function are reviewed. Third, potential crosstalk between oligodendrocytes and other cells in the brain is also summarized. Last, we discuss the therapeutic potential of oligodendrocyte‐based treatments in ICH. Our goal is to provide a comprehensive review on the biology and function of oligodendrocytes under both physiological and ICH conditions.     

脑出血早期血肿扩大危险因素的临床研究

目的探讨急性脑出血早期血肿扩大的危险因素。方法回顾性分析138例急性高血压性脑出血患者临床资料,血肿扩大者与血肿未扩大患者资料进行对比分析。结果 138例脑出血患者中有50例出现血肿扩大,单因素分析显示,两组的发病距首次行头部CT检查时间、入院格拉斯哥昏迷指数(GCS)评分、入院美国国立卫生研究院卒中量表(NIHSS)评分和凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、甘油三酯(TG)、高密度脂蛋白胆固醇(HDL-C)、载脂蛋白A1(APO-A1)、血糖及胱抑素C(Cys C)水平差异有统计学意义(P0.05);Logistic回归分析显示较短的发病距首次行头部CT检查时间(OR=1.374,95%CI=1.044~7.666,P0.05)、低入院GCS评分(OR=0.222,95%CI=0.092~0.533,P0.01)、高入院NIHSS评分(OR=1.735,95%CI=1.762~2.624,P0.01)、血清高水平HDL-C(OR=1.726,95%CI=1.546~2.313,P0.05)及血糖(OR=1.410,95%CI=1.027~1.934,P0.05)与脑出血急性期血肿扩大独立相关。结论低入院GCS评分、高入院NIHSS评分、血清高水平HDL-C及高血糖为脑出血早期血肿扩大的危险因素,脑出血发病后尽早行头部CT检查可提高血肿扩大发现率。