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中华养生保健 ›› 2024, Vol. 42 ›› Issue (2): 54-57.

• 临床研究 • 上一篇    下一篇

成人ICH患者基于MRI-DWI检查远隔病灶发生危险因素研究

蔡瑞兴1, 苏莉2, 张秦2, 谭家明3,*   

  1. 1.山东颐养健康集团莱芜中心医院介入科,山东 济南,271103;
    2.山东颐养健康集团莱芜中心医院神经内科,山东 济南,271103;
    3.山东颐养健康集团莱芜中心医院重症医学科,山东 济南,271103
  • 出版日期:2024-01-16 发布日期:2024-01-17
  • 通讯作者: *谭家明,E-mail:laiwutanjiaming1018@163.com。
  • 作者简介:蔡瑞兴(1978—),男,汉族,籍贯:山东省临沂市,本科,主任医师,研究方向:神经介入、外周介入、神经内科。

Risk Factors of Distant Lesions Based on MRI-DWI in Adult Patients with ICH

CAI Rui-xing1, SU Li2, ZHANG Qin2, TAN Jia-ming3,*   

  1. 1. Intervention Department, Laiwu Central Hospital of Shandong Health Care Group, Jinan Shandong, 271103, China;
    2. Neurology Department, Laiwu Central Hospital of Shandong Health Care Group, Jinan Shandong, 271103, China;
    3. Critical Care Medicine Department, Laiwu Central Hospital of Shandong Health Care Group, Jinan Shandong, 271103, China
  • Online:2024-01-16 Published:2024-01-17

摘要: 目的 探讨成人自发性脑出血(ICH)患者基于MRI-DWI检查远隔病灶发生危险因素,旨在为临床早期发现远隔病灶并给予针对性防治干预措施提供更多参考。方法 回顾性选取2016年1月—2021年6月山东颐养健康集团莱芜中心医院收治的406例成人ICH患者作为研究对象,均行MRI-DWI检查,并根据是否出现远隔病灶分组,包括出现远隔病灶组(78例)和未出现远隔病灶组(328例),分析一般资料和实验室检查指标,采用多因素Logistic回归模型评价成人ICH患者远隔病灶发生独立危险因素。结果 406例患者中78例出现远隔病灶,病灶数共110个,包括皮层-皮层下90个,基底节区16个,脑干和小脑各2个;远隔病灶直径2~20 mm,平均直径(8.33±3.69)mm,其中血肿对侧半球出现84个。出现远隔病灶组收缩压(SBP)水平、舒张压(DBP)水平、白细胞计数(WBC)水平、中性粒细胞计数(NEU)水平、中性粒细胞与淋巴细胞比值(NLR)水平及空腹血糖水平均显著高于未出现远隔病灶组,差异有统计学意义(P<0.05);单因素分析结果显示,SBP、DBP、WBC、NEU、NLR及空腹血糖水平均与成人ICH患者远隔病灶发生有关(P<0.05);多因素Logistic回归模型分析结果显示,高空腹血糖、高NEU及高NLR水平均是成人ICH患者远隔病灶发生独立危险因素(P<0.05)。结论 高空腹血糖、高NEU及高NLR水平成人ICH患者更易发生基于MRI-DWI检查远隔病灶,且多见皮层-皮层下区域。

关键词: 成人, 自发性脑出血, MRI, 远隔病灶, 危险因素

Abstract: Objective To investigate the risk factors of distant lesions based on MRI-DWI in adult patients with ICH to provide more references for early definition of distant lesions based on MRI-DWI and construct the prevention and treatment intervention. Methods 406 adult patients with ICH were retrospectively chosen in the period from January 2016 to June 2021 in Laiwu Central Hospital of Shandong Health Care Group. MRI-DWI were underwent in all patients and they were grouped according to whether there were distant lesions or not and included distant lesions detection group (78 cases) and non- distant lesions detection group (328 cases). The general data and laboratory inspection indicators were analyzed. Multivariate logistic regression model was used to evaluate the independent risk factors of distant lesions in adult patients with ICH. Results 78 cases in all 406 patients had distant lesions as total of 110 lesions. The levels of SBP, DBP, WBC, NEU, NLR and fasting blood glucose of distant lesions detection group were significantly higher than non-distant lesions detection group(P<0.05). Univariate analysis showed that SBP, DBP, WBC, NEU, NLR and fasting blood glucose were related to the occurrence of distant lesions in adult patients with ICH(P<0.05). Multivariate logistic regression analysis showed that high abdominal blood glucose, high neu and high NLR levels were independent risk factors for distant lesions in adult patients with ICH(P<0.05). Conclusion Adult ICH patients with high abdominal blood glucose, high neu and high NLR levels should be more prone to distant lesions based on MRI-DWI,and cortical subcortical areas may be more common.

Key words: adult, spontaneous intracerebral hemorrhage, MRI, distant lesions, risk factors

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