不同海拔地区幕上脑出血患者CT影像学特征对比OA
Comparison of imaging features of supratentorial intracerebral hemorrhage in patients at different altitudes
目的 探讨不同海拔地区幕上自发性脑出血患者影像学特征差异,并分析 CT 值的影响因素.方法 回顾性分析2023 年7 月—2025 年7 月因自发性幕上脑出血就诊于塔什库尔干塔吉克自治县人民医院(高海拔组)和新疆医科大学第一附属医院(低海拔组)的140 例患者的临床资料,包括基本信息(年龄、性别、慢性病)、影像学指标(血肿位置、血肿量、血肿平均 CT 值、血肿形状)及血液学指标(血常规、凝血功能检查).结果 共纳入140 例患者,基线资料比较显示,两组在年龄和性别构成方面差异无统计学意义(均 P>0.05).影像学特征方面,高海拔组血肿量大于低海拔组[(33.4±18.3)mL vs(22.4±15.7)mL,P<0.001],CT 值高于低海拔组[(68.8±2.7)HU vs(55.3±7.8)HU,P=0.029].两组在血肿位置分布和血肿形状方面的差异均无统计学意义(均 P>0.05).相关性分析表明,CT 值与血红蛋白浓度呈正相关(r=0.542,P<0.001).多因素线性回归分析显示,血红蛋白浓度(β=0.489,P<0.001)和海拔(β=0.218,P=0.012)是 CT值的独立影响因素,两者可解释 CT 值35.6%的变异(R2=0.356,P<0.001).结论 高海拔地区自发性脑出血患者血肿平均 CT 值升高与继发性红细胞增多密切相关.低氧环境通过多种机制影响脑出血的影像学表现,临床工作中应重视这些特殊影像学特征避免误诊.
Objective To investigate the differences in imaging features of supratentorial spontaneous intracerebral hemorrhage(ICH)between patients at different altitudes and to analyze the influencing factors of CT values.Methods The clinical data of 140 patients with spontaneous supratentorial ICH treated at Taxkorgan Tajik Autonomous County People's Hospital(high-altitude group)and the First Affiliated Hospital of Xinjiang Medical University(low-altitude group)from July 2023 to July 2025 were analyzed retrospectively,including basic information(age,gender,chronic diseases),imaging parameters(hematoma location,hematoma volume,mean hematoma CT value,hematoma shape),and hematological parameters(routine blood tests,coagulation function tests).Results A total of 140 patients were included in this study.Baseline comparisons showed no significant differences between the two groups in age and gender distribution(both P>0.05).Regarding imaging features,the high-altitude group had significantly larger hematoma volumes and significantly higher CT values[(68.8±2.7)HU vs(55.3±7.8)HU,P=0.029]compared to the low-altitude group[(33.4±18.3)mL vs(22.4±15.7)mL,P<0.001].No statistically significant differences were observed between the two groups in hematoma location distribution and hematoma shape(both P>0.05).Correlation analysis revealed a significant positive correlation between CT values and hemoglobin concentration(r=0.542,P<0.001).Multiple linear regression analysis demonstrated that hemoglobin concentration(β=0.489,P<0.001)and altitude(β=0.218,P=0.012)were independent factors influencing CT values,jointly explained 35.6%of the variance in CT values(adjusted R2=0.356,P<0.001).Conclusions The elevated mean hematoma CT values in patients with spontaneous ICH at high altitudes are closely associated with secondary polycythemia.Hypoxic environments influence the imaging manifestations of intracerebral hemorrhage through multiple mechanisms.Clinicians should pay attention to these distinctive imaging features to avoid misdiagnosis.
努尔艾力江·麦麦提艾力;江荣雷;夏天光;依日扎提·艾力;秦虎;汪永新
830000 乌鲁木齐,省部共建中亚高发病成因与防治国家重点实验,新疆医科大学第一附属医院神经外科||新疆医科大学神经系统肿瘤精准诊疗与临床转化重点实验室塔什地区第一人民医院神经外科武警特色医学中心神经外科830000 乌鲁木齐,省部共建中亚高发病成因与防治国家重点实验,新疆医科大学第一附属医院神经外科||新疆医科大学神经系统肿瘤精准诊疗与临床转化重点实验室830000 乌鲁木齐,省部共建中亚高发病成因与防治国家重点实验,新疆医科大学第一附属医院神经外科||新疆医科大学神经系统肿瘤精准诊疗与临床转化重点实验室830000 乌鲁木齐,省部共建中亚高发病成因与防治国家重点实验,新疆医科大学第一附属医院神经外科||新疆医科大学神经系统肿瘤精准诊疗与临床转化重点实验室
医药卫生
海拔脑出血影像学特征血红蛋白浓度
altitudeintracerebral hemorrhageimaging featurehemoglobin concentration
《临床神经外科杂志》 2026 (4)
361-366,6
省部共建中亚高发病成因与防治国家重点实验室高原病项目(SKL-HIDCA-2024-GY4)
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