Analysis of influencing factors of symptomatic cerebral infarction in patients with spontaneous intracerebral hemorrhage
10.3760/cma.j.cn371468-20241008-00468
- VernacularTitle:自发性脑出血患者伴发症状性脑梗死的影响因素分析
- Author:
Mengyang REN
1
;
Ailing ZHANG
1
;
Long TIAN
1
;
Na DING
1
Author Information
1. 河南中医药大学第五临床医学院（郑州人民医院）神经内科，郑州 450003
- Publication Type:Journal Article
- Keywords:
Intracerebral hemorrhage, spontaneous;
Symptomatic cerebral infarction;
Cerebral artery stenosis;
Risk factors
- From:
Chinese Journal of Behavioral Medicine and Brain Science
2025;34(4):340-345
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the risk factors for symptomatic cerebral infarction (SCI) in patients with spontaneous intracerebral hemorrhage (ICH).Methods:A total of 337 patients with spontaneous ICH admitted to the stroke center of Zhengzhou People’s Hospital were consecutively collected from May 2019 to March 2023. Patients were divided into the SCI group and without SCI group according to whether the presence of new neurological deficits consistent with diffusion-weighted imaging hyperintense lesions distant from the hematoma. Magnetic resonance was used to quantify cerebral small vessel disease imaging markers and the degree of cerebral artery stenosis (CAS). SPSS 25.0 software was used for data analysis. Univariate and multivariable Logistic regression models were adopted to assess risk factors associated with concomitant SCI. Subgroup analysis stratified by mean arterial pressure (MAP) tertiles was performed.Results:Compared with patients without SCI, patients with SCI have more histories of ischemic stroke, higher rates of complication of pneumonia and deep venous thrombosis, higher baseline systolic blood pressure, greater MAP change, higher periventricular white matter hyperintensities score and deep white matter hyperintensities (DWMHs) score, and more severe CAS (all P<0.05). Multivariable regression analysis showed that, the degree of CAS ( B=1.095, OR=2.989, 95% CI=1.645-5.432, P<0.001) and DWMHs score ( B=0.789, OR=2.201, 95% CI=1.163-4.166, P=0.015) were risk factors for ICH patients with SCI. Compared with patients with mild CAS, the proportion of SCI significantly increased in patients with moderate and severe CAS in the maximum MAP change group (both P<0.05). Compared with patients with mild DWMHs, the proportion of SCI in patients with severe DWMHs in the maximum MAP change group significantly increased ( P=0.002). Conclusion:Severe CAS and DWMHs are independent risk factors for SCI after ICH, especially with greater fluctuations in MAP change.
