High rate of microbleed formation following primary intracerebral hemorrhage.
High rate of microbleed formation following primary intracerebral hemorrhage.
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原发性脑出血后微出血形成率很高。
DOI：
10.1111/ijs.12607
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发表时间：
2015
期刊：
影响因子：
--
通讯作者：
Kidwell,ChelseaS
中科院分区：
文献类型：
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作者：
Mackey,Jason;Wing,JeffreyJ;Norato,Gina;Sobotka,Ian;Menon,RaviS;Burgess,RichardE;Gibbons,MChris;Shara,NawarM;Fernandez,Stephen;Jayam-Trouth,Annapurni;Russell,Laura;Edwards,DorothyF;Kidwell,ChelseaS
背景我们试图调查以非裔美国人为主的人群中脑出血后微出血的发生频率，并确定新的微出血形成的预测因素。目的和/或假设调查脑出血后新的微出血的频率和预测因素。方法DECHER研究是一项前瞻性的、纵向的、基于磁共振的队列研究，旨在评估脑出血人群中微出血危险因素的种族/民族差异，并评估微出血对预后的影响。我们在两个时间段内评估了新的微出血形成：从基线到30天和从30天到第一年。结果在200名登记参加破译的受试者中，84人在所有需要的时间点进行了磁共振成像，以满足分析标准。在基线到第30天的分析中，11(13.1%)出现了新的微出血，而在第30天到第1年的分析中有25(29.8%)出现了新的微出血。Logistic回归分析显示，基线微出血次数[优势比1·05(95%可信区间1·01，1·08)，P=0·01]与30天后新微出血的形成有关。预测1年后新发微出血的Logistic回归模型包括基线微出血数[优势比1·05(1·00，1·11)，P=0·046]、基线年龄[优势比1·05(1·00，1·10)，P=0·04]和脑白质疾病评分[优势比1·18(0·96，1·45)。P=0·115]。总体而言，84名脑出血患者中有28名(33.3%)在脑出血后第一年的某个时间点形成了新的微出血。结论我们发现，在存活一年的脑出血患者中，有三分之一出现了新的微出血，这表明这是一种动态的、快速进展的血管病变。需要进一步的研究来检验新的微出血形成对患者预后的影响。
BackgroundWe sought to investigate the frequency of microbleed development following intracerebral hemorrhage in a predominantly African-American population and to identify predictors of new microbleed formation.Aims and/or hypothesisTo investigate the frequency and predictors of new microbleeds following intracerebral hemorrhage.MethodsThe DECIPHER study was a prospective, longitudinal, magnetic resonance-based cohort study designed to evaluate racial/ethnic differences in risk factors for microbleeds and to evaluate the prognostic impact of microbleeds in this intracerebral hemorrhage population. We evaluated new microbleed formation in two time periods: from baseline to 30 days and from 30 days to year 1.ResultsOf 200 subjects enrolled in DECIPHER, 84 had magnetic resonance imaging at all required time points to meet criteria for this analysis. In the baseline to day 30 analysis, 11 (13·1%) had new microbleeds, compared with 25 (29·8%) in the day 30 to year 1 analysis. Logistic regression analysis demonstrated that baseline number of microbleeds [odds ratio 1·05 (95% confidence interval 1·01, 1·08),P= 0·01] was associated with new microbleed formation at 30 days. A logistic regression model predicting new microbleed at one-year included baseline number of microbleeds [odds ratio 1·05 (1·00, 1·11),P= 0·046], baseline age [odds ratio 1·05 (1·00, 1·10),P= 0·04], and white matter disease score [odds ratio 1·18 (0·96, 1·45).P= 0·115]. Overall, 28 of 84 (33·3%) intracerebral hemorrhage subjects formed new microbleeds at some point in the first year post-intracerebral hemorrhage.ConclusionsWe found that one-third of intracerebral hemorrhage subjects in this cohort surviving one-year developed new microbleeds, which suggests a dynamic and rapidly progressive vasculopathy. Future studies are needed to examine the impact of new microbleed formation on patient outcomes.