Leukoaraiosis is associated with clinical symptom severity, poor neurological function prognosis and stroke recurrence in mild intracerebral hemorrhage: a prospective multi-center cohort study.
Leukoaraiosis is associated with clinical symptom severity, poor neurological function prognosis and stroke recurrence in mild intracerebral hemorrhage: a prospective multi-center cohort study.
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DOI：
10.4103/1673-5374.322469
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发表时间：
2022-04
影响因子：
6.1
通讯作者：
Fu Y
中科院分区：
文献类型：
--
作者：
Xu TQ;Lin WZ;Feng YL;Shen FX;Chen J;Wu WW;Zhu XD;Gu L;Fu Y
脑白质疏松症（LA）是由脑小血管缺血性损伤引起的，其可能归因于血管密度降低、脑血管新生减少、脑血流量减少或脑中微循环功能障碍。在这项研究中，我们从中国五家医院招募了357例轻度脑出血（ICH）患者，并分析了LA与入院时临床症状严重程度、3个月时神经功能预后和1年卒中复发的关系。根据Fazekas量表评分将患者分组：无LA（n = 83）、轻度LA（n = 64）、中度LA（n = 98）和重度LA（n = 112）。更严重的LA、更大的血肿体积和入院时更高的血糖水平与更严重的神经功能缺损相关。LA越严重、年龄越大、血肿体积越大，3个月时神经功能预后越差。此外，中度至重度LA、入院血糖和无症状脑梗死与1年中风复发相关。这些结果表明，LA严重程度可能是个体ICH易感性的潜在标志，其特征在于对脑内发作的耐受性差或ICH后恢复能力差。评估轻度ICH患者LA的严重程度可能有助于神经科医生优化治疗方案。本研究于2011年3月10日获得上海交通大学附属瑞金医院伦理委员会批准（批件号：12）。
Leukoaraiosis (LA) results from ischemic injury in small cerebral vessels, which may be attributable to decreased vascular density, reduced cerebrovascular angiogenesis, decreased cerebral blood flow, or microcirculatory dysfunction in the brain. In this study, we enrolled 357 patients with mild intracerebral hemorrhage (ICH) from five hospitals in China and analyzed the relationships between LA and clinical symptom severity at admission, neurological function prognosis at 3 months, and 1-year stroke recurrence. Patients were divided into groups based on Fazekas scale scores: no LA (n = 83), mild LA (n = 64), moderate LA (n = 98) and severe LA (n = 112). More severe LA, larger hematoma volume, and higher blood glucose level at admission were associated with more severe neurological deficit. More severe LA, older age and larger hematoma volume were associated with worse neurological function prognosis at 3 months. In addition, moderate-to-severe LA, admission glucose and symptom-free cerebral infarction were associated with 1-year stroke recurrence. These findings suggest that LA severity may be a potential marker of individual ICH vulnerability, which can be characterized by poor tolerance to intracerebral attack or poor recovery ability after ICH. Evaluating LA severity in patients with mild ICH may help neurologists to optimize treatment protocols. This study was approved by the Ethics Committee of Ruijin Hospital Affiliated to Shanghai Jiao Tong University (approval No. 12) on March 10, 2011.
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DOI：
10.1136/bmj.c3666
发表时间：
2010-07-26
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Debette S;Markus HS
通讯作者：
Markus HS
影响因子：
158.5
作者：
Feigin, Valery L.;Nguyen, Grant;Roth, Gregory A.
通讯作者：
Roth, Gregory A.
影响因子：
4.1
作者：
Lin, Qing;Huang, Wen-Qing;Tzeng, Chi-Meng
通讯作者：
Tzeng, Chi-Meng
影响因子：
48
作者：
Wilson, Duncan;Ambler, Gareth;Werring, David J.
通讯作者：
Werring, David J.
影响因子：
8.3
作者：
Venema, Simone M. Uniken;Marini, Sandro;Rosand, Jonathan
通讯作者：
Rosand, Jonathan