脑粉样血管病变中发作的发生率和风险因素
Brin E Freund1, Sofia S Sanchez-Boluarte2, Karen Blackmon3
1Department of Neurology, Mayo Clinic, Jacksonville, Florida, USA.
European journal of neurology
|May 31, 2023
概括
发作发生在近20%的脑粉样血管病变 (CAA) 患者中,经常作为第一个症状出现. 额叶内出血,带有炎症的CAA和表面性 siderosis是CAA中发作的关键风险因素.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 脑血管疾病 脑血管疾病
背景情况:
- 大脑粉状血管病变 (CAA) 是内出血 (ICH) 的重要原因.
- 是已知的ICH并发症,但其在不同CAA患者队列中的发病率和风险因素仍未得到充分研究.
研究的目的:
- 为了调查发作的发生率和确定发作风险因素在诊断为脑粉样血管病变 (CAA) 的患者的异质队列.
- 分析CAA患者中与发作相关的临床特征和并发症.
主要方法:
- 在佛罗里达梅奥诊所 (2015-2021) 对284名患有CAA的患者进行了回顾性研究 (根据修改的波士顿标准v2.0定义).
- 临床特征的分析,包括叶片性ICH,皮质/凸度下大脑下垂体出血 (cSAH),表面性 siderosis 和 CAA 与炎症 (CAA-ri).
- 进行了单变量和多变量分析,以确定发作风险因素.
主要成果:
- 19.7%的CAA患者经历了发作,其中37.5%的发作是最初的诊断特征.
- 发作在女性中更为频繁,并与大叶ICH,cSAH,表面 siderosis 和 CAA-ri.相关.
- 在调整年龄和性别后,Lobar ICH (OR 2.1),CAA-ri (OR 3.8) 和表面 siderosis (OR 3.7) 独立地与发作风险增加有关.
结论:
- 发作是脑粉样血管病变患者的常见情况.
- 额叶内出血,炎症的CAA和表面性 siderosis是CAA中发作的独立预测因素.
- 这些发现可以为CAA患者的优化临床监测和管理策略提供信息.
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