Combined effect of cortical superficial siderosis and cerebral microbleed on short-term and long-term outcomes after intracerebral haemorrhage
Combined effect of cortical superficial siderosis and cerebral microbleed on short-term and long-term outcomes after intracerebral haemorrhage
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DOI：
10.1136/svn-2023-002439
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发表时间：
2023-11-10
影响因子：
5.9
通讯作者：
Tong，Lu-sha
中科院分区：
文献类型：
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作者：
Jin，Yujia;Huang，Yu-hui;Tong，Lu-sha
背景与目的脑出血（intracerebral haemorrhage，ICH）的发病与皮质表面铁质沉着症（cortex superficial siderosis，cSS）和脑微出血（cerebral microbleeding，CMB）有关。我们的目的是调查cSS和CMB对结果后ICH.MethodsBased单中心中风登记数据库的综合效果，自发性脑出血患者在发病后48小时内进行CT扫描，随后进行MRI检查。符合条件的患者根据MRI磁共振成像的cSS和CMB分为4组（cSS-CMB-、cSS-CMB+、cSS+CMB-、cSS+CMB+）。主要结局为入院时血肿体积和3个月时改良兰金量表评分≥3的不利结局。次要结果是全因死亡，复发中风和ICH随访期间（中位数随访2.0年，IQR 1.0-3.0年）。ResultsA共673例患者被确定为1044例自发性ICH。131例（19.5%）患有cSS，468例（69.5%）患有CMB。cSS+CMB+患者在3个月时的不良结局发生率最高，随访期间的全因死亡、复发性卒中和ICH发生率也最高。在cSS−患者中，CMB与较小的血肿相关（β −0.13; 95% CI −0.22至−0.03; p=0.009），但仍增加了复发性ICH（OR 4.6; 95% CI 1.3至15.6; p=0.015）和卒中（OR 2.0; 95% CI 1.0至4.0; p=0.049）的风险。CMB的这些影响变得不显着的背景下cSS+.ConclusionsPatients与不同组合的cSS和CMB有不同的模式的短期和长期的结果。虽然CMB与抑制性血肿有关，但它不能改善长期结局。试验注册号NCT 04803292。
Background and purposeCortical superficial siderosis (cSS) and cerebral microbleed (CMB) have distinct effects on intracerebral haemorrhage (ICH). We aim to investigate the combined effect of cSS and CMB on outcomes after ICH.MethodsBased on a single-centre stroke registry database, patients with spontaneous ICH who had CT scan within 48 hours after ictus and MRI subsequently were identified. Eligible patients were divided into four groups (cSS-CMB−, cSS-CMB+, cSS+CMB−, cSS+CMB+) according to cSS and CMB on susceptibility-weighted image of MRI. Primary outcomes were haematoma volume on admission and unfavourable outcome defined as modified Rankin Scale scores ≥3 at 3 months. Secondary outcomes were all-cause death, recurrence of stroke and ICH during follow-up (median follow-up 2.0 years, IQR 1.0–3.0 years).ResultsA total of 673 patients were identified from 1044 patients with spontaneous ICH. 131 (19.5%) had cSS and 468 (69.5%) had CMB. Patients with cSS+CMB+ had the highest rate of poor outcome at 3 months, as well as all-cause death, recurrent stroke and ICH during follow-up. In cSS− patients, CMB was associated with smaller haematoma (β −0.13; 95% CI −0.22 to −0.03; p=0.009), but it still increased risks of recurrent ICH (OR 4.6; 95% CI 1.3 to 15.6; p=0.015) and stroke (OR 2.0; 95% CI 1.0 to 4.0; p=0.049). These effects of CMB became unremarkable in the context of cSS+.ConclusionsPatients with different combinations of cSS and CMB have distinct patterns of short-term and long-term outcomes. Although CMB is related to restrained haematoma, it does not improve long-term outcomes.Trial registration numberNCT04803292.