中华老年心脑血管病杂志2025，Vol.27Issue(1) ：80-83.DOI:10.3969/j.issn.1009-0126.2025.01.018

不同的扩大的血管周围间隙对急性缺血性脑卒中患者自发性出血性转化影响的差异性

Impacts of EPVS of different site and severity on spontaneous hemorrhagic transformation in AIS patients

欧茹 刘益民 黄文纯 李其岩
中华老年心脑血管病杂志2025，Vol.27Issue(1) ：80-83.DOI:10.3969/j.issn.1009-0126.2025.01.018
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不同的扩大的血管周围间隙对急性缺血性脑卒中患者自发性出血性转化影响的差异性

Impacts of EPVS of different site and severity on spontaneous hemorrhagic transformation in AIS patients

欧茹 1刘益民 1黄文纯 2李其岩3
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作者信息

  • 1. 528000 佛山市南海区第六人民医院脑科
  • 2. 528000 佛山市南海区第六人民医院放射科
  • 3. 528000 佛山市南海区第六人民医院病案室
  • 折叠

摘要

目的 探讨不同组别的扩大的血管周围间隙(enlarged perivascular space,EPVS)对急性缺血性脑卒中患者自发性出血性转化的影响的差异性.方法 选取2021年1月至2024年6月南海区第六人民医院脑科收治的急性缺血性脑卒中患者595例,入院后72 h内完善MRI检查,收集入组患者的头颅MRI EPVS情况.根据头颅MRI结果分为EPVS组384例和无EPVS组211例.EPVS根据发生部位分为基底节患者135例、半卵圆中心患者132例、中脑患者117例;EPVS根据严重程度分级分为轻度患者155例、重度患者229例.在住院期间第7～10天复查头颅CT或者MRI 了解颅内情况,根据第2次复查的头颅CT或MRI结果了解患者是否发生自发性出血性转化,分析并比较不同部位及不同严重程度级别EPVS患者自发性出血性转化发生率的差异.结果 EPVS组出血性转化比例显著高于无EPVS组,差异有统计学意义(27.08％vs 8.53％,P＜0.01).基底节患者自发性出血性转化发生率显著高于半卵圆中心和中脑患者,差异有统计学意义(40.00％vs 21.97％vs 17.95％,P＜0.01);重度患者自发性出血性转化比例显著高于轻度患者,差异有统计学意义(33.19％vs 18.06％,P＜0.01).结论 不同部位及严重程度级别的EPVS对急性缺血性脑卒中患者自发性出血性转化的影响具有差异性.基底节、严重程度为重度EPVS的急性缺血性脑卒中患者发生自发性出血性转化的风险更高,能更好预测自发性出血性转化的发生.

Abstract

Objective To investigate the difference of spontaneous hemorrhagic transformation(HT)in enlarged perivascular space(EPVS)of different site and various dilation in patients with acute ischemic stroke.Methods A total of 595 patients admitted to our department acute ischemic stroke from January 2021 to June 2024 were recruited in this study.Brain magnetic resonance ima-ging was conducted in all of them within 72 h after admission,and their EPVS status was collect-ed.According to the results of brain MRI,they were divided into EPVS(384 cases)and non-EPVS(211 cases)groups.Based on EPVS site,the EPVS group was further assigned into basal ganglia(135 cases),centrum semiovale(132 cases),and midbrain(117 cases)subgroups,and based on the severity,the group was also into mild(155 cases)and severe(229 cases)subgroups.Brain CT or MRI examination was re-performed on the 7th to 10th day during hospitalization to investigate the intracranial condition,and then spontaneous HT was evaluated.The incidence of spontaneous HT in the EPVS patients of different sites and severity was analyzed and compared.Results The incidence of spontaneous HT was significantly higher in the EPVS group than the non-EPVS group(27.08％vs 8.53％,P＜0.01),and the incidence of spontaneous HT was also obviously higher in the basal ganglia subgroup than the centrum semiovale subgroup and then the midbrain subgroup(40.00％vs 21.97％vs 17.95％,P＜0.01).What's more,the severe subgroup had nota-bly higher incidence of spontaneous HT than the mild subgroup(33.19％vs 18.06％,P＜0.01).Conclusion There is difference in spontaneous HT among acute ischemic stroke patients with EPVS of different site and severity.EPVS in the basal ganglia and of severe level indicates a high-er risk of spontaneous HT,and the two features can better predict the incidence of spontaneous HT.

关键词

缺血性卒中/磁共振成像/自发性出血性转化/扩大的血管周围间隙

Key words

ischemic stroke/magnetic resonance imaging/spontaneous hemorrhagic transforma-tion/enlarged perivascular space

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出版年

2025
中华老年心脑血管病杂志
中国人民解放军总医院

中华老年心脑血管病杂志

CSTPCD北大核心
影响因子：2.328
ISSN：1009-0126
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