Abstract:

Objective To analyze risk factors of hematoma volume of cerebral hemorrhage in different location. Methods A total of 373 patients with cerebral hemorrhage from 2013 to 2017 years in our hospital were enrolled. According to the hemorrhage location, the patients were divided into basal ganglia hemorrhage group and lobar hemorrhage group, and the clinical data were analyzed retrospectively. Results Compared with lobar hemorrhage group, the average systolic blood pressure (P=0.034) and diastolic blood pressure (P=0.001), the content of serum uric acid (P=0.001) were higher in basal ganglia hemorrhage group, in which the patient had a higher proportion of the history of hypertension (P<0.001) and alcohol drinking (P=0.034). The average age (P<0.001), the levels of fibrin degradation product(FDP)(P=0.001) and D-dimers (P=0.003), the hematoma volume(P<0.001) in lobar hemorrhage group were higher than ganglia hemorrhage group, and the patients in lobar group had a higher proportion of the history of cerebral hemorrhage (P=0.02). Binary Logistics regression analysis showed that the risk of lobar hemorrhage increased 5.7%(P<0.001) when age increased one additional year. The risk of recurrent lobar hemorrhage was 3.27 times than that of basal ganglia hemorrhage (P=0.025) as the patients had a history of cerebral hemorrhage, and the risk of recurrent lobar hemorrhage was 0.477 times (P=0.031) than that of basal ganglia hemorrhage as the patients had a history of hypertension. Using multivariable linear regression to analyze hematoma volume change, we found that age （β=-1.04, P=0.002）, international normalized ratio(INR)（β=14.219, P=0.008）, the content of uric acid （β=-0.008, P=0.046）, high density lipoprotein cholesterol (β=5.393, P=0.003), antiplatelet therapy (β=4.706, P=0.002) were independent predictive factors of basal ganglia cerebral hemorrhage. While the content of uric acid (β=-0.041, P=0.015), prior drinking history (β=-15.189, P=0.010), prior smoking history (β=12.579, P=0.005) and history of ischemic stroke (β=12.899, P=0.031) were independent predictive factors of lobar hemorrhage. Conclusions The risk factors of basal ganglia and lobar hematoma volume were different, and their independent predictive factors of hematoma volume were only partially overlapped. It suggests that the pathophysiological mechanisms determining the hematoma volume are not same in different locations.

Key words: Cerebral hemorrhage, Risk factors, Haematoma volume