Epidemiology, Risk Factors, and Clinical Features of Intracerebral Hemorrhage: An Update.
Epidemiology, Risk Factors, and Clinical Features of Intracerebral Hemorrhage: An Update.
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DOI：
10.5853/jos.2016.00864
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发表时间：
2017-01
影响因子：
8.2
通讯作者：
Yoon BW
中科院分区：
文献类型：
--
作者：
An SJ;Kim TJ;Yoon BW
脑出血（ICH）是卒中的第二种最常见亚型，是一种通常导致严重残疾或死亡的危重疾病。ICH在亚洲人、老年人、男性和中低收入国家更常见。ICH的病死率很高（1个月时为40%，1年时为54%），只有12%至39%的幸存者可以实现长期功能独立。ICH的危险因素有高血压、吸烟、过量饮酒、低胆固醇血症和药物。老年、男性、亚裔、慢性肾脏疾病、脑淀粉样血管病（CAA）和脑微出血（CMB）可增加ICH的风险。临床表现根据血肿的大小和位置以及出血的脑室内扩展而不同。CAA相关ICH患者通常伴有认知障碍。近年来，随着老年房颤患者的增加，抗凝相关的ICH也在增加。由于非维生素K拮抗剂口服抗凝剂（NOAC）目前正在取代华法林，NOAC相关ICH的管理已成为一个新出现的问题。
Intracerebral hemorrhage (ICH) is the second most common subtype of stroke and a critical disease usually leading to severe disability or death. ICH is more common in Asians, advanced age, male sex, and low- and middle-income countries. The case fatality rate of ICH is high (40% at 1 month and 54% at 1 year), and only 12% to 39% of survivors can achieve long-term functional independence. Risk factors of ICH are hypertension, current smoking, excessive alcohol consumption, hypocholesterolemia, and drugs. Old age, male sex, Asian ethnicity, chronic kidney disease, cerebral amyloid angiopathy (CAA), and cerebral microbleeds (CMBs) increase the risk of ICH. Clinical presentation varies according to the size and location of hematoma, and intraventricular extension of hemorrhage. Patients with CAA-related ICH frequently have concomitant cognitive impairment. Anticoagulation related ICH is increasing recently as the elderly population who have atrial fibrillation is increasing. As non-vitamin K antagonist oral anticoagulants (NOACs) are currently replacing warfarin, management of NOAC-associated ICH has become an emerging issue.