Study on influencing factors of cerebral vasospasm after aneurysmal subarachnoid hemorrhage
Objective To study the influencing factors of cerebral vasospasm(CVS)after aneurysmal subarachnoid hemorrhage(ASAH).Methods 66 patients with aneurysmal subarachnoid hemorrhage were divided into CVS group and non-CVS group according to whether CVS occurred or not,with 33 cases in each group.Social demographic data,symptoms and physical conditions,scale scores,brain CT findings,clinical treatment,aneurysm characteristics and related laboratory tests of all patients before admission were collected.The influencing factors of CVS after aneurysmal subarachnoid hemorrhage were analyzed by multivariate Logistic regression.Results A total of 66 patients met the enrollment criteria and completed the study,most of whom aged 40-60 years old,and more of them were female in both groups.There was no statistically significant difference between the two groups in comparison of age,gender,history of smoking,history of caffeine use,aneurysm status(size,localization,height,diameter),Glasgow Coma Scale(GCS)score,Hunt-Hess Scale(HHS)grade,Fischer Scale(FS)grade,albumin nadir,maximum C-reactive protein(CRP)recorded,whether lumbar puncture and/or ventricular-peritoneal shunt,and whether mechanical ventilation after endovascular surgery(P＞0.05).There were statistically significant differences between the two groups in terms of papilledema induced decreased visual acuity,intracerebral hemorrhage,hydrocephalus,aneurysm width,modified Rankin scale(mRS)score,maximum urea recorded,maximum white blood cell count(WBC)recorded,maximum international normalized ratio(INR)recorded,and lowest platelet count(PLT)(P＜0.05).Multivariate Logistic regression analysis was performed on the statistically significant indicators of univariate analysis.The results showed that the increase of maximum urea recorded,maximum WBC recorded and maximum INR recorded was the risk factor for CVS after aneurysmal subarachnoid hemorrhage(OR=1.235,1.219,1.373;P＜0.05).Papilledema induced decreased visual acuity,intracerebral hemorrhage,hydrocephalus,aneurysm width,mRS score and lowest PLT were not influencing factors for CVS after aneurysmal subarachnoid hemorrhage(P＞0.05).Conclusion The intensity of intracranial inflammation in patients with aneurysmal subarachnoid hemorrhage may be directly related to the occurrence and adverse consequences of CVS.
万方数据
维普
