不明原因的蛛网膜下腔出血预后危险因素分析及长期临床随访(1)
【摘要】 目的：探究血管影像检查阴性的原因不明的蛛网膜下腔出血患者预后的危险因素，并对患者进行长期临床随访，观察患者长期预后。方法：回顾性分析2011年4月-2014年5月天津医科大学总医院神经外科收治的92例血管影像学检查阴性的蛛网膜下腔出血患者的临床资料。对92例患者的性别、年龄(≤60岁、>60岁)、有无高血压病史、有无糖尿病病史、是否吸烟进行单因素和多因素分析。
结果：单因素分析显示，不明原因的蛛网膜下腔出血患者的年龄、高血压与不良预后均存在相关性(P<0.05)，而性别、糖尿病、吸烟与患者预后均不相关(P>0.05)。Logistic回归分析提示年龄、高血压是影响预后的危险因素(P<0.05)。出院后成功随访62例患者，其中1例死于心脏病，1例患慢性硬膜下血肿，3例患者出现脑梗死，无再次出血患者。结论：高血压、高龄为不明原因的蛛网膜下腔出血患者预后不良的危险因素，出院时mRS 0～1分患者长期预后良好。
【关键词】 阴性蛛网膜下腔出血； 危险因素； mRS评分； 预后
Analysis of Prognostic Risk Factors of Subarachnoid Hemorrhage with Unknown Causes and Long-term Clinical Follow-up/LIU Shengjie，ZHANG Zhen，WANG Zhe，et al.//Medical Innovation of China，2018，15(26)：-125
【Abstract】 Objective：To explore the risk factors for the prognosis of patients with angiography negative subarachnoid hemorrhage，and to observe the long-term prognosis of patients by long-term clinical follow-up.
Method：The clinical data of 92 patients with subarachnoid hemorrhage who were admitted to the General Hospital of Tianjin Medical University from April 2011 to May 2014 were retrospectively analyzed.The gender，age(less than 60 years old，>60 years old)，history of hypertension，history of diabetes and smoking were analyzed.Result：Univariate analysis showed that age，hypertension and poor prognosis of patients with unexplained subarachnoid hemorrhage were correlated(P<0.05)，while gender，diabetes，smoking were not correlated with patient prognosis (P>0.05).Logistic regression analysis suggested that age and hypertension were risk factors for prognosis(P<0.05).After discharge，62 patients were successfully followed up，including 1 patient who died of heart disease，1 patient with chronic subdural hematoma，3 patients with cerebral infarction， and no patients with recurrent hemorrhage.Conclusion：Hypertension and advanced age are the risk factors for the prognosis of patients with angiography negative subarachnoid hemorrhage，the long-term prognosis of mRS 0-1 patients is good.
【Key words】 Angiography negative subarachnoid hemorrhage； Risk factor； mRS score； Prognosis
First-author’s address：Tianjin Medical University General Hospital，Tianjin 300052，China
doi：10.3969/j.issn.1674-4985.2018.26.031
蛛網膜下腔出血是神经外科医生常见的临床疾病，自发性蛛网膜下腔出血多由动脉瘤破裂出血所致，较少原因为脑血管畸形破裂或动脉夹层、肿瘤及其他血管异常；DSA仍然是确诊蛛网膜下腔出血原因的金标准[1-2]；临床上时常能遇到影像检查不能确诊原因的蛛网膜下腔出血，占总数的2%～24%[3]；其出血原因多认为可能为静脉源性[4]。血管影像阴性蛛网膜下腔出血患者预后危险因素不明确[5]，长期随访研究较少。本研究旨在探究影响血管影像检查阴性的原因不明的蛛网膜下腔出血患者预后的危险因素。此外，对患者进行长期临床随访，观察患者长期预后。, 百拇医药(刘盛杰 张振 王者 赵岩 杨新宇)
结果：单因素分析显示，不明原因的蛛网膜下腔出血患者的年龄、高血压与不良预后均存在相关性(P<0.05)，而性别、糖尿病、吸烟与患者预后均不相关(P>0.05)。Logistic回归分析提示年龄、高血压是影响预后的危险因素(P<0.05)。出院后成功随访62例患者，其中1例死于心脏病，1例患慢性硬膜下血肿，3例患者出现脑梗死，无再次出血患者。结论：高血压、高龄为不明原因的蛛网膜下腔出血患者预后不良的危险因素，出院时mRS 0～1分患者长期预后良好。
【关键词】 阴性蛛网膜下腔出血； 危险因素； mRS评分； 预后
Analysis of Prognostic Risk Factors of Subarachnoid Hemorrhage with Unknown Causes and Long-term Clinical Follow-up/LIU Shengjie，ZHANG Zhen，WANG Zhe，et al.//Medical Innovation of China，2018，15(26)：-125
【Abstract】 Objective：To explore the risk factors for the prognosis of patients with angiography negative subarachnoid hemorrhage，and to observe the long-term prognosis of patients by long-term clinical follow-up.
Method：The clinical data of 92 patients with subarachnoid hemorrhage who were admitted to the General Hospital of Tianjin Medical University from April 2011 to May 2014 were retrospectively analyzed.The gender，age(less than 60 years old，>60 years old)，history of hypertension，history of diabetes and smoking were analyzed.Result：Univariate analysis showed that age，hypertension and poor prognosis of patients with unexplained subarachnoid hemorrhage were correlated(P<0.05)，while gender，diabetes，smoking were not correlated with patient prognosis (P>0.05).Logistic regression analysis suggested that age and hypertension were risk factors for prognosis(P<0.05).After discharge，62 patients were successfully followed up，including 1 patient who died of heart disease，1 patient with chronic subdural hematoma，3 patients with cerebral infarction， and no patients with recurrent hemorrhage.Conclusion：Hypertension and advanced age are the risk factors for the prognosis of patients with angiography negative subarachnoid hemorrhage，the long-term prognosis of mRS 0-1 patients is good.
【Key words】 Angiography negative subarachnoid hemorrhage； Risk factor； mRS score； Prognosis
First-author’s address：Tianjin Medical University General Hospital，Tianjin 300052，China
doi：10.3969/j.issn.1674-4985.2018.26.031
蛛網膜下腔出血是神经外科医生常见的临床疾病，自发性蛛网膜下腔出血多由动脉瘤破裂出血所致，较少原因为脑血管畸形破裂或动脉夹层、肿瘤及其他血管异常；DSA仍然是确诊蛛网膜下腔出血原因的金标准[1-2]；临床上时常能遇到影像检查不能确诊原因的蛛网膜下腔出血，占总数的2%～24%[3]；其出血原因多认为可能为静脉源性[4]。血管影像阴性蛛网膜下腔出血患者预后危险因素不明确[5]，长期随访研究较少。本研究旨在探究影响血管影像检查阴性的原因不明的蛛网膜下腔出血患者预后的危险因素。此外，对患者进行长期临床随访，观察患者长期预后。, 百拇医药(刘盛杰 张振 王者 赵岩 杨新宇)