渗透性表面面积指数对幕上脑出血早期血肿扩大的预测研究

目的 探讨渗透性表面面积指数（permeability-surface area product index，PSI）预测幕上脑出血早期血肿扩大的敏感程度。方法 连续入组2007年9月～2012年4月首都医科大学附属北京天坛医院急性幕上脑出血患者40例（发病6 h内），比较入院时及发病24 h时的计算机断层扫描（computed tomography，CT）的血肿体积，根据血肿体积增加是否大于33%者分为血肿扩大组和未扩大组。通过计算机断层扫描血管成像（computed tomography angiography，CTA）的点征和灌注CT的渗透性表面面积及PSI，比较PSI预测血肿扩大的灵敏度及特异度。结果 血肿扩大的发生率为45%，血肿扩大组水肿组织PSI为（2.60 0.51）高于未扩大组（2.27 0.34）（P=0.040）；水肿组织PSI诊断血肿扩大的灵敏度为88.89%，特异度为68.18%。结论 脑出血急性期血肿扩大后PSI增加，PSI预测幕上脑出血急性期血肿扩大敏感性高。

Study of the Correlation Between Permeability-Surface Area Product and Hematoma Expansion in Acute Intracerebral Hemorrhage

Objective To investigate the sensitivity between permeability-surface area product index and hematoma expansion in acute intracerebral hemorrhage.
Methods Forty patients with acute intracerebral hemorrhage(onset within 6 hours) who hospitalized in Beijing Tiantan Hospital from September 2007 to April 2012 were included in this study. Computed tomography(CT) perfusion was taken within 6 hours after the patients’ symptom onset, and CT scan was rechecked at 24 hours after the patients’ symptom onset. The correlation between permeability-surface area product and hematoma expansion was evaluated.
Results The incidence rate of hematoma enlargement was 45%. The permeability-surface area product index(PSI)(2.60 0.51) of the edema tissue of patients with hematoma enlargement was bigger than those without(2.27 0.34)(P=0.040). In the diagnosis of hematoma enlargement, the sensitivity of PSI of edema was 88.89%, the specificity was 68.18%.
Conclusion In the acute phase of cerebral hemorrhage, PSI is increased, and PSI is very sensitive in prediction of the occurrence of hematoma enlargement.