脑小血管病影像学标志物与自发性高血压脑出血的相关性研究进展

doi:10.3969/j.issn.1673-5765.2022.12.019

摘要/Abstract

摘要： 临床中脑小血管病患者发生自发性高血压脑出血的现象多见，且很多患者合并脑小血管病的影像学标志物，本综述对二者临床上的相关性进行总结。脑白质高信号的严重程度与自发性高血压脑出血复发的风险呈正相关，增加死亡率和不良预后；总微出血数量与血肿扩大显著相关，可预测患者的不良预后；血管周围间隙扩大或腔隙性梗死合并自发性高血压脑出血的临床研究较少，有待于进一步阐明；多个影像学特征的脑小血管病患者，其脑小血管病总体负荷评分越高，临床不良功能预后及脑出血复发风险越高。

文章导读： 脑小血管病合并自发性高血压脑出血患者，脑白质高信号越严重、总微出血数量越多、脑小血管病总体负荷评分越高，临床不良功能预后及脑出血复发风险越高。

关键词: 脑小血管病; 高血压脑出血; 脑小血管病负荷; 脑白质高信号; 脑微出血; 血管周围间隙扩大; 腔隙性梗死

Abstract: Many patients with cerebral small vessel disease (CSVD) in clinical practice developed spontaneous hypertensive intracerebral hemorrhage, and many CSVD patients had CSVD imaging markers. This article reviewed the progress of clinical correlation of spontaneous intracerebral hemorrhage with CSVD. Most studies suggested that the severity of white matter hyperintensity was positively correlated with the risk of intracerebral hemorrhage recurrence, and increased mortality and poor prognosis; the total number of microbleeds was significantly correlated with hematoma enlargement, and could predict the poor prognosis of patients. There are few studies on the correlation of enlarged perivascular space or lacunar infarction with spontaneous hypertensive intracerebral hemorrhage, and the evidence on their relationship is insufficient. For patients with multiple CSVD imaging features, the higher the total score of CSVD load, the higher the risk of poor functional prognosis and intracerebral hemorrhage recurrence.

Key words: Cerebral small vessel disease; Hypertensive intracerebral hemorrhage; Cerebral small vessel disease load; White matter hyperintensity; Cerebral microbleed; Enlarged perivascular space; Lacunar infarct

郑占军, 赵性泉. 脑小血管病影像学标志物与自发性高血压脑出血的相关性研究进展[J]. 中国卒中杂志, 2022, 17(12): 1396-1402.

ZHENG Zhanjun, ZHAO Xingquan. Advances in Correlation of Imaging Markers of Cerebral Small Vessel Disease with Spontaneous Hypertensive Intracerebral Hemorrhage[J]. Chinese Journal of Stroke, 2022, 17(12): 1396-1402.

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