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中华脑血管病杂志(电子版) ›› 2021, Vol. 15 ›› Issue (02) : 77 -82. doi: 10.11817/j.issn.1673-9248.2021.02.003

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脑出血血肿扩大的研究进展
蔡宾1, 彭斌1,()   
  1. 1. 100730 中国医学科学院北京协和医学院 北京协和医院神经科
  • 收稿日期:2020-05-30 出版日期:2021-04-01
  • 通信作者: 彭斌
  • 基金资助:
    国家重点研发计划精准医学研究重点专项子课题(2016YFC0901004)

Progress in hematoma expansion in patients with intracerebral hemorrhage

Bin Cai1, Bin Peng1,()   

  1. 1. Department of Neurology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing 100730, China
  • Received:2020-05-30 Published:2021-04-01
  • Corresponding author: Bin Peng
引用本文:

蔡宾, 彭斌. 脑出血血肿扩大的研究进展[J/OL]. 中华脑血管病杂志(电子版), 2021, 15(02): 77-82.

Bin Cai, Bin Peng. Progress in hematoma expansion in patients with intracerebral hemorrhage[J/OL]. Chinese Journal of Cerebrovascular Diseases(Electronic Edition), 2021, 15(02): 77-82.

脑出血具有高发病率、高病死率及高致残率等特点,且目前缺乏有效的治疗手段。早期血肿扩大的发生与脑出血患者预后不良风险增加高度相关,而且该过程被认为是可以干预的重要治疗靶点,因此,早期识别血肿扩大发生风险较高的患者并给予积极治疗对改善脑出血预后至关重要。本文现对脑出血血肿扩大的定义、发生机制、预测指标及治疗等方面的研究进展作一综述。

Intracerebral hemorrhage is characterized by high prevalence, mortality and disability rate, and unfortunately few proven treatments are available at present. Early hematoma expansion is significantly associated with worse outcome in patients with intracerebral hemorrhage. Therefore, it is of great importance to early identify the patients with high risk of hematoma expansion, and to provide them with active interventions to improve the prognosis. In the current study, we have reviewed the progress in definition, mechanism, predictive factors and treatments of hematoma expansion in patients with intracerebral hemorrhage.

1
Qureshi AI, Mendelow AD, Hanley DF. Intracerebral haemorrhage [J]. Lancet, 2009, 373(9675): 1632-1644.
2
van Asch CJ, Luitse MJ, Rinkel GJ, et al. Incidence, case fatality, and functional outcome of intracerebral haemorrhage over time, according to age, sex, and ethnic origin: a systematic review and meta-analysis [J]. Lancet Neurol, 2010, 9(2): 167-176.
3
Feigin VL, Lawes CM, Bennett DA, et al. Worldwide stroke incidence and early case fatality reported in 56 population-based studies: a systematic review [J]. Lancet Neurol, 2009, 8(4): 355-369.
4
Davis SM, Broderick J, Hennerici M, et al. Hematoma growth is a determinant of mortality and poor outcome after intracerebral hemorrhage [J]. Neurology, 2006, 66(8): 1175-1181.
5
Fujii Y, Takeuchi S, Sasaki O, et al. Multivariate analysis of predictors of hematoma enlargement in spontaneous intracerebral hemorrhage [J]. Stroke, 1998, 29(6): 1160-1166.
6
Kazui S, Naritomi H, Yamamoto H, et al. Enlargement of spontaneous intracerebral hemorrhage. Incidence and time course [J]. Stroke, 1996, 27(10): 1783-1787.
7
Brott T, Broderick J, Kothari R, et al. Early hemorrhage growth in patients with intracerebral hemorrhage [J]. Stroke, 1997, 28(1): 1-5.
8
Leira R, Davalos A, Silva Y, et al. Early neurologic deterioration in intracerebral hemorrhage: predictors and associated factors [J]. Neurology, 2004, 63(3): 461-467.
9
Delcourt C, Huang Y, Arima H, et al. Hematoma growth and outcomes in intracerebral hemorrhage: the INTERACT1 study [J]. Neurology, 2012, 79(4): 314-319.
10
Brouwers HB, Greenberg SM. Hematoma expansion following acute intracerebral hemorrhage [J]. Cerebrovasc Dis, 2013, 35(3): 195-201.
11
Dowlatshahi D, Demchuk AM, Flaherty ML, et al. Defining hematoma expansion in intracerebral hemorrhage: relationship with patient outcomes [J]. Neurology, 2011, 76(14): 1238-1244.
12
Brouwers HB, Falcone GJ, Mcnamara KA, et al. CTA spot sign predicts hematoma expansion in patients with delayed presentation after intracerebral hemorrhage [J]. Neurocrit Care, 2012, 17(3): 421-428.
13
Fisher CM. Pathological observations in hypertensive cerebral hemorrhage [J]. J Neuropathol Exp Neurol, 1971, 30(3): 536-550.
14
Fujii Y, Tanaka R, Takeuchi S, et al. Hematoma enlargement in spontaneous intracerebral hemorrhage [J]. J Neurosurg, 1994, 80(1): 51-57.
15
Delgado AJ, Yoo AJ, Stone MJ, et al. Systematic characterization of the computed tomography angiography spot sign in primary intracerebral hemorrhage identifies patients at highest risk for hematoma expansion: the spot sign score [J]. Stroke, 2009, 40(9): 2994-3000.
16
Ederies A, Demchuk A, Chia T, et al. Postcontrast CT extravasation is associated with hematoma expansion in CTA spot negative patients [J]. Stroke, 2009, 40(5): 1672-1676.
17
Broderick JP, Diringer MN, Hill MD, et al. Determinants of intracerebral hemorrhage growth: an exploratory analysis [J]. Stroke, 2007, 38(3): 1072-1075.
18
陈国芳, 秦晓凌, 平蕾, 等. 原发性脑出血早期血肿增大的临床分析 [J]. 中华神经科杂志, 2009, 42(7): 484-485.
19
Toyoda K, Okada Y, Minematsu K, et al. Antiplatelet therapy contributes to acute deterioration of intracerebral hemorrhage [J]. Neurology, 2005, 65(7): 1000-1004.
20
Cucchiara B, Messe S, Sansing L, et al. Hematoma growth in oral anticoagulant related intracerebral hemorrhage [J]. Stroke, 2008, 39(11): 2993-2996.
21
Maruishi M, Shima T, Okada Y, et al. Involvement of fluctuating high blood pressure in the enlargement of spontaneous intracerebral hematoma [J]. Neurol Med Chir (Tokyo), 2001, 41(6): 300-304, 304-305.
22
Wada R, Aviv RI, Fox AJ, et al. CT angiography "spot sign" predicts hematoma expansion in acute intracerebral hemorrhage [J]. Stroke, 2007, 38(4): 1257-1262.
23
Li Q, Liu Q J, Yang WS, et al. Island Sign: An Imaging Predictor for Early Hematoma Expansion and Poor Outcome in Patients With Intracerebral Hemorrhage [J]. Stroke, 2017, 48(11): 3019-3025.
24
Li Q, Zhang G, Huang YJ, et al. Blend Sign on Computed Tomography: Novel and Reliable Predictor for Early Hematoma Growth in Patients With Intracerebral Hemorrhage [J]. Stroke, 2015, 46(8): 2119-2123.
25
Li Q, Zhang G, Xiong X, et al. Black Hole Sign: Novel Imaging Marker That Predicts Hematoma Growth in Patients With Intracerebral Hemorrhage [J]. Stroke, 2016, 47(7): 1777-1781.
26
Goldstein JN, Fazen LE, Snider R, et al. Contrast extravasation on CT angiography predicts hematoma expansion in intracerebral hemorrhage [J]. Neurology, 2007, 68(12): 889-894.
27
Li N, Wang Y, Wang W, et al. Contrast extravasation on computed tomography angiography predicts clinical outcome in primary intracerebral hemorrhage: a prospective study of 139 cases [J]. Stroke, 2011, 42(12): 3441-3446.
28
Demchuk AM, Dowlatshahi D, Rodriguez-Luna D, et al. Prediction of haematoma growth and outcome in patients with intracerebral haemorrhage using the CT-angiography spot sign (PREDICT): a prospective observational study [J]. Lancet Neurol, 2012, 11(4): 307-314.
29
Barras CD, Tress BM, Christensen S, et al. Density and shape as CT predictors of intracerebral hemorrhage growth [J]. Stroke, 2009, 40(4): 1325-1331.
30
Barras CD, Tress BM, Christensen S, et al. Quantitative CT densitometry for predicting intracerebral hemorrhage growth [J]. AJNR Am J Neuroradiol, 2013, 34(6): 1139-1144.
31
Boulouis G, Morotti A, Brouwers HB, et al. Association Between Hypodensities Detected by Computed Tomography and Hematoma Expansion in Patients With Intracerebral Hemorrhage [J]. JAMA Neurol, 2016, 73(8): 961-968.
32
陆菁菁, 季楠, 赵元立, 等. 进展型脑出血的影像学和临床预测 [J]. 中华医学杂志, 2007, 87(7): 438-441.
33
Ng D, Churilov L, Mitchell P, et al. The CT Swirl Sign Is Associated with Hematoma Expansion in Intracerebral Hemorrhage [J]. AJNR Am J Neuroradiol, 2018, 39(2): 232-237.
34
李卓星, 褚晓凡, 窦汝香, 等. 不规则血肿形态的量化评价 [J]. 中华神经科杂志, 2008, 41(5): 335-338.
35
Yogendrakumar V, Demchuk AM, Aviv RI, et al. Location of intracerebral haemorrhage predicts haematoma expansion [J]. Eur Stroke J, 2017, 2(3): 257-263.
36
Lee SM, Park HS, Choi JH, et al. Location and characteristics of warfarin associated intracranial hemorrhage [J]. J Cerebrovasc Endovasc Neurosurg, 2014, 16(3): 184-192.
37
Brouwers HB, Biffi A, Ayres AM, et al. Apolipoprotein E genotype predicts hematoma expansion in lobar intracerebral hemorrhage [J]. Stroke, 2012, 43(6): 1490-1495.
38
Roh D, Sun CH, Murthy S, et al. Hematoma Expansion Differences in Lobar and Deep Primary Intracerebral Hemorrhage [J]. Neurocrit Care, 2019, 31(1): 40-45.
39
Mayer SA, Brun NC, Begtrup K, et al. Recombinant activated factor VII for acute intracerebral hemorrhage [J]. N Engl J Med, 2005, 352(8): 777-785.
40
Mayer SA, Brun NC, Begtrup K, et al. Efficacy and safety of recombinant activated factor VII for acute intracerebral hemorrhage [J]. N Engl J Med, 2008, 358(20): 2127-2137.
41
Mayer SA, Davis SM, Skolnick BE, et al. Can a subset of intracerebral hemorrhage patients benefit from hemostatic therapy with recombinant activated factor Ⅶ? [J]. Stroke, 2009, 40(3): 833-840.
42
Anderson CS, Huang Y, Wang JG, et al. Intensive blood pressure reduction in acute cerebral haemorrhage trial (INTERACT): a randomised pilot trial [J]. Lancet Neurol, 2008, 7(5): 391-399.
43
Anderson CS, Huang Y, Arima H, et al. Effects of early intensive blood pressure-lowering treatment on the growth of hematoma and perihematomal edema in acute intracerebral hemorrhage: the Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage Trial (INTERACT) [J]. Stroke, 2010, 41(2): 307-312.
44
Anderson CS, Heeley E, Huang Y, et al. Rapid blood-pressure lowering in patients with acute intracerebral hemorrhage [J]. N Engl J Med, 2013, 368(25): 2355-2365.
45
Qureshi AI, Palesch YY, Martin R, et al. Effect of systolic blood pressure reduction on hematoma expansion, perihematomal edema, and 3-month outcome among patients with intracerebral hemorrhage: results from the antihypertensive treatment of acute cerebral hemorrhage study [J]. Arch Neurol, 2010, 67(5): 570-576.
46
Arima H, Anderson CS, Wang JG, et al. Lower treatment blood pressure is associated with greatest reduction in hematoma growth after acute intracerebral hemorrhage [J]. Hypertension, 2010, 56(5): 852-858.
47
Qureshi AI, Palesch YY, Barsan WG, et al. Intensive Blood-Pressure Lowering in Patients with Acute Cerebral Hemorrhage [J]. N Engl J Med, 2016, 375(11): 1033-1043.
48
Huang LQ, Zhu GF, Deng YY, et al. Hypertonic saline alleviates cerebral edema by inhibiting microglia-derived TNF-α and IL-1β-induced Na-K-Cl Cotransporter up-regulation [J]. J Neuroinflammation, 2014, 11: 102.
49
Hauer EM, Stark D, Staykov D, et al. Early continuous hypertonic saline infusion in patients with severe cerebrovascular disease [J]. Crit Care Med, 2011, 39(7): 1766-1772.
50
Wagner I, Hauer EM, Staykov D, et al. Effects of continuous hypertonic saline infusion on perihemorrhagic edema evolution [J]. Stroke, 2011, 42(6):1540-1545.
51
Schreibman DL, Hong CM, Keledjian K, et al. Mannitol and Hypertonic Saline Reduce Swelling and Modulate Inflammatory Markers in a Rat Model of Intracerebral Hemorrhage [J]. Neurocrit Care, 2018, 29(2): 253-263.
52
Qureshi AI, Suri MF, Ringer AJ, et al. Regional intraparenchymal pressure differences in experimental intracerebral hemorrhage: effect of hypertonic saline [J]. Crit Care Med, 2002, 30(2): 435-441.
53
Koenig MA, Bryan M, JL3rd Lewin, et al. Reversal of transtentorial herniation with hypertonic saline [J]. Neurology, 2008, 70(13): 1023-1029.
54
Qureshi AI, Wilson DA, Traystman RJ. Treatment of elevated intracranial pressure in experimental intracerebral hemorrhage: comparison between mannitol and hypertonic saline [J]. Neurosurgery, 1999, 44(5): 1055-1064.
55
Harutjunyan L, Holz C, Rieger A, et al. Efficiency of 7.2% hypertonic saline hydroxyethyl starch 200/0.5 versus mannitol 15% in the treatment of increased intracranial pressure in neurosurgical patients-a randomized clinical trial [ISRCTN62699180] [J]. Crit Care, 2005, 9(5): R530-R540.
56
Kamel H, Navi BB, Nakagawa K, et al. Hypertonic saline versus mannitol for the treatment of elevated intracranial pressure: a meta-analysis of randomized clinical trials [J]. Crit Care Med, 2011, 39(3): 554-559.
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