目的 探讨CT影像在高血压脑出血风险预测及预后评估中的价值.方法 前瞻性录入42例连续的急性高血压脑出血患者入院时临床资料及颅脑CT影像特征,随访患者发病3个月的生存质量(做mRS评分)和总体认知功能(做MMSE评分),对CT影像特征与临床预后的关系进行单因素和多因素分析.结果 血肿体积、血肿周围水肿体积是发病14 d神经功能缺损程度的预测因素;年龄、血肿体积和首次NIHSS评分是发病3个月预后不良的独立风险预测因素;出血量超过10 ml神经组织的损伤程度及对预后的影响将明显增加;发病年龄是认知功能障碍的预测因素.结论 CT影像特征可作为高血压脑出血疾病转归的评价指标,可为高血压脑出血早期治疗及预后评估提供影像学依据.%Objective To evaluate the value of brain CT features in prediction and prognosis in patients with hypertensive intracerebral hemorrhage. Methods 42 serial patients suffered from acute hypertensive intracerebral hemorrhage, with related clinical materials such as sex, age and neurological deficit severity scale as well as the brain CT findings were screened prospectively. Outcome associated to neurological recovery and cognitive level were respectively assessed using the modified Rankin scale( mRS) and the mini -mental state examination( MMSE)after onset three months. The relationship between CT features and clinical prognosis was analyzed in multivariate logistic regression. Results The volume of hematoma and of perihematomal edema were predictors of neurological deficit severity 14 days later. The volume of hematoma, sex and the first NIHSS score were independent risk predictors of poor outcome. The degree of brain tissue injury and the effect on prognosis imposed by the volume of hemorrhage greater than 10 ml were more significant. The age of patients was a predictor of cognitive impairment. Conclusion CT features may be used to evaluate the clinical prognosis, and provide imaging evidence for individually early therapeutic strategy of hypertensive intracerebral hemorrhage.
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