脑出血患者的脑微出血研究

目的研究脑出血患者脑微出血的发生、分布、相关因素及与腔隙性脑梗死和脑白质改变等其他微小血管病变的关系。方法对连续住院的106例急性脑出血患者进行临床及磁共振研究。记录脑微出血的病灶数量、部位、有无腔隙性脑梗死灶、脑白质改变及其程度。依据有无脑微出血分为脑微出血组(62例)和无脑微出血组(44例)。结果脑微出血组患者病灶分布于皮质及皮质下(50.7%)、基底节及丘脑(34.1%)、脑干(9.0%)、小脑(6.2%);脑微出血组患者男性多,高血压及既往脑梗死发生率高(P<0.05);脑微出血发生的相关因素有腔隙性脑梗死(OR=7.188,P<0.001)及脑白质病变(OR=19.847,P<0.001)。结论脑微出血是严重的易于出血的脑微小血管病变,对脑出血患者进行二级预防具有指导意义。

The cerebral microbleeds in patients with intracerebral hemorrhage

Objective To investigate the frequency and location of cerebral microbleeds(CMBs) in patients with intracerebral hemorrhage and the association with lacunar infarction and ischemic brain white matter changes.Methods 106 patients with acute intracerebral hemorrhage were recruited consecutively.MRI was performed and the clinical risk factors were evaluated.The number and the location of CMBs,the incidence of lacunar infarction and ischemic brain white matter changes were studied on MRI images.The patients were divided into two groups based on the occurrence of CMBs on MRI images.The group with CMBs had sixty-two patients and the group without CMBs had forty-four patients.Results Sixty-two patients were found to have CMBs,which were distributed at different parts of brain including cortical-subcortical(50.7%),thalamus-basal ganglia(34.1%),brain stem(9.0%), cerebellum(6.2%).There was a correlation between the incidence of CMBs and lacunar infarction(OR=7.188,P<0.001) or ischemic brain white matter changes(OR=19.847,P<0.001) on MRI images.Conclusions The finding of CMBs in patients with intracerebral hemorrhage is an indicator of severe microangiopathy of brain with an increased risk of bleeding.It has clinical significance for the secondary prevention in patients with intracerebral hemorrhage.