Intracranial hemorrhage in adult patients with hematological malignancies.
Intracranial hemorrhage in adult patients with hematological malignancies.
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DOI：
10.1186/1741-7015-10-97
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发表时间：
2012-08-29
期刊：
影响因子：
9.3
通讯作者：
Tien HF
中科院分区：
文献类型：
--
作者：
Chen CY;Tai CH;Cheng A;Wu HC;Tsay W;Liu JH;Chen PY;Huang SY;Yao M;Tang JL;Tien HF
患有各种血液系统恶性肿瘤的成年患者的颅内出血（ICH）的临床特征和结果有限。 2001年至2010年间，共有2,574名在同一所大学医院收治的被诊断患有血液恶性肿瘤的成年患者纳入本研究。对临床特征、影像报告和结果进行回顾性分析。共有 72 名患者（48 名男性和 24 名女性）患有 ICH，中位年龄为 56 岁（范围为 18 至 86 岁）。成年血液系统恶性肿瘤患者的 ICH 总体发生率为 2.8%。急性髓系白血病（AML）患者的ICH发生率高于其他血液恶性肿瘤患者（6.3% vs 1.1%，P = 0.001）。 ICH在淋巴瘤累及中枢神经系统（CNS）的患者中比累及CNS的急性白血病患者更常见（P <0.001）。 ICH发生部位包括大脑皮层（60例，83%）、基底节（13例，18%）、小脑（10例，14%）和脑干（5例，7%）。共有 33 名患者 (46%) 出现多灶性出血。总共有 56 名患者（77%）出现脑实质内出血，22 名患者（31%）出现硬膜下出血，15 名患者（21%）出现蛛网膜下腔出血（SAH），3 名患者（4%）出现硬膜外出血。共有 22 名患者患有 2 种或以上类型的 ICH。总共有 46 名 (64%) 患者在诊断后 30 天内死于 ICH，无论血液恶性肿瘤的类型如何。多变量分析揭示了三个独立的预后因素：凝血酶原时间延长（P = 0.008）、SAH（P = 0.021）和多灶性脑出血（P = 0.026）。 AML患者ICH的发生率高于其他血液恶性肿瘤患者。但在颅内恶性疾病患者中，中枢神经系统受累淋巴瘤患者比中枢神经系统受累急性白血病患者更容易发生脑出血。无论血液恶性肿瘤的类型如何，死亡率都相似。对 ICH 位置和类型的神经影像学研究可以帮助预测血液恶性肿瘤患者的预后。
Clinical characteristics and outcomes of intracranial hemorrhage (ICH) among adult patients with various hematological malignancies are limited. A total of 2,574 adult patients diagnosed with hematological malignancies admitted to a single university hospital were enrolled into this study between 2001 and 2010. The clinical characteristics, image reports and outcomes were retrospectively analyzed. A total of 72 patients (48 men and 24 women) with a median age of 56 (range 18 to 86) had an ICH. The overall ICH incidence was 2.8% among adult patients with hematological malignancies. The incidence of ICH was higher in acute myeloid leukemia (AML) patients than in patients with other hematological malignancies (6.3% vs 1.1%, P = 0.001). ICH was more common among patients with central nervous system (CNS) involvement of lymphoma than among patients with CNS involved acute leukemia (P <0.001). Sites of ICH occurrence included the cerebral cortex (60 patients, 83%), basal ganglia (13 patients, 18%), cerebellum (10 patients, 14%), and brainstem (5 patients, 7%). A total of 33 patients (46%) had multifocal hemorrhages. In all, 56 patients (77%) had intraparenchymal hemorrhage, 22 patients (31%) had subdural hemorrhage, 15 patients (21%) had subarachnoid hemorrhage (SAH), and 3 patients (4%) had epidural hemorrhage. A total of 22 patients had 2 or more types of ICH. In all, 46 (64%) patients died of ICH within 30 days of diagnosis, irrespective of the type of hematological malignancy. Multivariate analysis revealed three independent prognostic factors: prolonged prothrombin time (P = 0.008), SAH (P = 0.021), and multifocal cerebral hemorrhage (P = 0.026). The incidence of ICH in patients with AML is higher than patients with other hematological malignancies. But in those with intracranial malignant disease, patients with CNS involved lymphoma were more prone to ICH than patients with CNS involved acute leukemia. Mortality was similar regardless of the type of hematological malignancy. Neuroimaging studies of the location and type of ICH could assist with prognosis prediction for patients with hematological malignancies.
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影响因子：
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作者：
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DOI：
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发表时间：
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影响因子：
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