肝硬化并发脑出血与高血压脑出血的对比研究

摘要/Abstract

摘要：

【摘要】目的探讨肝硬化并发脑出血与高血压脑出血临床特点的区别。方法比较首都医科大学附属北京地坛医院收治的36例肝硬化并发脑出血患者与同期我院收治的52例高血压脑出血患者出血量、出血部位及临床特点。结果本研究中肝硬化并发脑出血平均出血量低于高血压脑出血平均出血量（P=0.038）。两组患者脑出血部位有显著差异（P<0.001），肝硬化并发脑出血出血部位以脑叶（44.44%）为主，而高血压脑出血多位于基底节区（80.77%）。肝硬化脑出血多部位出血者占16.67%，而本组高血压脑出血中无多部位出血，两组有显著差异（P<0.001）。结论与高血压脑出血相比，肝硬化并发脑出血出血量较少，部位以脑叶多见，且亦多发。

文章导读： 本文探讨了肝硬化并发脑出血的临床及影像学特点，有助于此类患者的诊治。

关键词: 肝硬化; 脑出血; 高血压; 临床特点

Abstract:

【Abstract】 Objective To investigate the difference of clinical features, volume of hemorrhage and the location of cerebral hemorrhage between hepatic cirrhosis complicated cerebral hemorrhage and hypertensive cerebral hemorrhage. Methods Thirty-six hepatic cirrhosis complicated cerebral hemorrhage patients and 52 hypertensive cerebral hemorrhage patients who were hospitalized in our hospital from October 2010 to May 2014 were enrolled in our study. We collected the data of all patients included including clinical features, volume of hemorrhage and the location of hemorrhage. The two sets of data were analyzed. Results Hepatic cirrhosis complicated cerebral hemorrhage had specific clinical features in compared with hypertensive cerebral hemorrhage. The average volume of hepatic cirrhosis complicated hemorrhage was significantly less than hypertensive cerebral hemorrhage patients (P=0.038). The location of cerebral hemorrhage was significant different between the two groups (P<0.01). Hemorrhage was mainly located at the cortex (accounted for 44.44%) in patients with liver cirrhosis, and tended to be multiple (accounted for 16.67%), while the location of hemorrhage was mainly at the basal ganglia (accounted for 80.77%) in hypertensive patients. Conclusion Compared with hypertensive cerebral hemorrhage, the average volume of hepatic cirrhosis complicated hemorrhage was significantly less. The bleeding site was mainly in the cortex, and multiple.

Key words: Hepatic cirrhosis; Cerebral hemorrhage; Hypertension; Clinical feature

薛成莲1，黄宇明1，崔志章2. 肝硬化并发脑出血与高血压脑出血的对比研究[J]. 中国卒中杂志, 2015, 10(03): 238-241.

XUE Cheng-Lian*, HUANG Yu-Ming, CUI Zhi-Zhang. . Comparison of Hepatic Cirrhosis Complicated Cerebral Hemorrhage and Hypertensive Cerebral Hemorrhage [J]. Chinese Journal of Stroke, 2015, 10(03): 238-241.

参考文献

参考文献

1 应力, 王朝晖, 严艳. 肝硬化合并脑出血21例分析[J]. 中国误诊学杂志, 2010, 10:201.

2 Gronbaek H, Johnsen SP, Jepsen P, et al. Liver cirrhosis, other liver diseases, and risk of hospitalization intracerebral haemorrhage:a Danish population-based case control study[J]. BMC Gastroenterol, 2008, 24:16.

3 侯峻冰. 失代偿性肝硬化并发脑出血20例临床观察[J]. 中西医结合心脑血管病杂志, 2012, 10:884-885.

4 王朝晖, 应力, 姜春萌. 肝硬化合并脑出血的临床研究[J]. 中华急诊医学杂志, 2007, 16:78-79.

5 Hoya K, Tanaka Y, Uchida T, et al. Intracerebral hemorrhage in patients with chronic liver disease[J].Neurol Med Chir (Tokyo), 2012, 52:181-185.

6 Inagawa T. Risk factors for primary intracerebral hemorrhage in patients in Izumo City, Japan[J]. Neurosurg Rev, 2007, 30:225-234.

7 Jackson CA, Sudlow CL. Is hypertension a more frequent risk factor for deep than for lobar supratentorial intracerebral haemorrhage[J]. J Neurol Neurosurg Psychiatry, 2006, 77:1244-1252.

8 葛均波, 徐永健, 梅长林, 等. 内科学[M]. 8版. 北京:人民卫生出版社, 2013:419-425.

9 王拥军, 崔丽英, 董强, 等. 中华人民共和国卫生行业标准:成人自发性脑出血诊断标准(ws 320-2010)[M]. 北京:中国标准出版社, 2010:1-6.

10 中国高血压防治指南修订委员会. 中国高血压防治指南2010[J]. 中华心血管病杂志, 2011, 39:579-616.

11 McCormick WF, Rosenfield DB. Massive brain hemorrhage:a review of 144 case and an examination of their causes[J]. Stroke, 1973, 4:946-954.

12 Huang HH, Lin HH, Shih YL, et al. Spontaneous intracranial hemorrhage in cirrhotic patients[J]. Clin Neurol Neurosurg, 2008, 110:253-258.

13 Arase Y, Kobayashi M, Kawamura Y, et al. Impact of virus clearance for the development of hemorrhagic stroke in chronic hepatitis C[J]. J Med Virol, 2014, 86:169-175.

14 贾建平, 陈生弟, 崔丽英, 等. 神经病学[M]. 7版. 北京:人民卫生出版社, 2013:188-189.

15 张津华, 付志新, 荆宏建, 等. 肝硬化合并脑出血的临床分析[J]. 中国实用神经疾病杂志, 2009, 12:61-62.

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