The Predictive Values of Different Small Vessel Disease Scores on Clinical Outcomes in Mild ICH Patients.
The Predictive Values of Different Small Vessel Disease Scores on Clinical Outcomes in Mild ICH Patients.
复制标题
不同小血管疾病评分对轻度脑出血患者临床结果的预测价值
DOI：
10.5551/jat.61267
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发表时间：
2021-09-01
影响因子：
4.4
通讯作者：
Fu Y
中科院分区：
文献类型：
--
作者：
Xu T;Feng Y;Wu W;Shen F;Ma X;Deng W;Zhang B;Hu J;Fu Y
目的：探讨不同小血管疾病（SVD）评分对轻度脑出血（ICH）患者功能恢复及临床脑血管事件的预测价值。
方法：本研究纳入意识清醒的轻度ICH且未手术的患者，并进一步将其分为脑淀粉样血管病（CAA）-ICH组和高血压（HTN）-ICH组。评估单个SVD标志物的严重程度，包括腔隙、脑微出血（CMBs）、血管周围间隙扩大（EPVS）、白质高信号（WMH）和皮质表面铁沉积（cSS）。进一步计算原始SVD评分、改良SVD评分、精细SVD评分、CAA - SVD评分以及SVD标志物总数。采用改良Rankin量表评估功能恢复情况。将卒中复发定义为因明确诊断为卒中再次入院。
结果：共纳入163例ICH患者（60例CAA - ICH和103例HTN - ICH）。在CAA - ICH组中，CAA - SVD评分（比值比=3.429；95%置信区间（CI）=1.518 - 7.748）对功能依赖的预测效果最佳，其中cSS严重程度可能起关键作用（比值比=4.665；95%CI = 1.388 - 15.679）。SVD标志物总数[风险比（HR）=3.765；95%CI = 1.467 - 9.663]能更好地识别CAA - ICH患者的卒中复发。在HTN - ICH中，虽然SVD标志物总数（HR = 2.136；95%CI = 1.218 - 3.745）也显示与卒中复发相关，但这种效应似乎与腔隙的影响有关（HR = 5.064；95%CI = 1.697 - 15.116）。
结论：CAA - SVD评分和SVD标志物总数可能识别出预后不良的轻度CAA - ICH患者。然而，在预测HTN - ICH患者的卒中复发时，关注腔隙而非SVD的总体负担可能更好。
Aim: To explore the predictive values of different small vessel disease (SVD) scores on functional recoveries and the clinical cerebrovascular events in mild intracerebral hemorrhage (ICH). Methods: In this study, we enrolled conscious and mild ICH patients without surgery and further divided them into the cerebral amyloid angiopathy (CAA)-ICH group and hypertension (HTN)-ICH group. The severity of individual SVD markers, including lacunes, cerebral microbleeds (CMBs), enlarged perivascular spaces (EPVS), white matter hyperintensity (WMH), and cortical superficial siderosis (cSS), was evaluated. The original SVD score, modified SVD score, refined SVD score, and CAA-SVD score and the total number of SVD markers were further calculated. Functional recoveries were evaluated using the modified Rankin scale. Recurrences of stroke were defined as readmission to the hospital with a definite diagnosis of stroke. Results: A total of 163 ICH patients (60 CAA-ICH and 103 HTN-ICH) were included in the study. The CAA-SVD score (OR=3.429; 95% confidence interval (CI)=1.518–7.748) had the best predictive effect on functional dependence in the CAA-ICH group, among which cSS severities probably played a vital role (OR=4.665; 95% CI=1.388–15.679). The total number of SVD markers [hazard ratio (HR)=3.765; 95% CI=1.467–9.663] can better identify stroke recurrences in CAA-ICH. In HTN-ICH, while the total number of SVD markers (HR=2.136; 95% CI=1.218–3.745) also demonstrated association with recurrent stroke, this effect seems to be related with the influence of lacunes (HR=5.064; 95% CI=1.697–15.116). Conclusions: The CAA-SVD score and the total number of SVD markers might identify mild CAA-ICH patients with poor prognosis. However, it would be better to focus on lacunes rather than on the overall burden of SVD to predict recurrent strokes in HTN-ICH.
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影响因子：
29
作者：
Charidimou A;Martinez-Ramirez S;Reijmer YD;Oliveira-Filho J;Lauer A;Roongpiboonsopit D;Frosch M;Vashkevich A;Ayres A;Rosand J;Gurol ME;Greenberg SM;Viswanathan A
通讯作者：
Viswanathan A
影响因子：
4.8
作者：
Huijts M;Duits A;van Oostenbrugge RJ;Kroon AA;de Leeuw PW;Staals J
通讯作者：
Staals J
影响因子：
48
作者：
Greenberg, Steven M.;Vernooij, Meike W.;Cordonnier, Charlotte;Viswanathan, Anand;Salman, Rustorn Al-Shahi;Warach, Steven;Launer, Lenore J.;Van Buchem, Mark A.;Breteler, Monique M. B.
通讯作者：
Breteler, Monique M. B.
影响因子：
9.9
作者：
Staals J;Makin SD;Doubal FN;Dennis MS;Wardlaw JM
通讯作者：
Wardlaw JM
影响因子：
6.3
作者：
Xiong, Li;Boulouis, Gregoire;Viswanathan, Anand
通讯作者：
Viswanathan, Anand