目的：对脑微出血与颈动脉狭窄的相关性进行讨论。方法患者入院后均行颅脑MRI与颈动脉彩超检查，了解患者脑微出血及颈动脉狭窄情况。结果67例患者中，轻度狭窄患者脑微出血30个，中度狭窄有36个，重度狭窄有46个，P＜0.05，差异有统计学意义。结论脑微出血与颈动脉狭窄之间存在相关性，且狭窄程度越重，脑微出血数目越多。

Objective To disscuss the correlation of brain hemorrhage and carotid stenosis.Methods After admission all patients were admitted to check brain magnetic resonance imaging (MRI) and carotid artery, understand the microcerebral hemorrhage and carotid artery stenosis in patients.Results In 67 cases of patients, 30 cases were mild stenosis cerebral hemorrhage, 36 cases were moderate stenosis, 46 cases wer severe stenosis,P< 0.05, the statistically difference was signiifcant.Conclusion Microcerebral hemorrhage and carotid stenosis are relevant, the heavier of the degree stenosis, the more number of microbrain hemorrhage.

目的：观察分析小骨窗微创脑出血清除术治疗高血压脑出血疗效。方法对高血压脑出血患者实施小骨窗微创脑出血清除术进行治疗，观察患者的血肿清除情况、并发症发生率以及病死率。结果通过进行小骨窗微创脑出血清除术，患者的血肿清除率有显著的提高，并发症发生率以及病死率得以有效降低。结论小骨窗微创脑出血清除术治疗高血压脑出血疾病有较为显著的疗效以及优势，术后创伤较小，且能够有效的恢复患者的生活质量，预后效果较好。

Objective Observe and analyse the curative effect in the treatment of hypertensive cerebral hemorrhage in small bone window craniotomy for brain hemorrhage. Methods Treated the patients with dissection for treatment of cerebral hemorrhage in small bone window craniotomy for hypertensive cerebral hemorrhage. Observaed patients with hematoma clearance, complication rate and mortality rate. Results Through the removal of cerebral hemorrhage in small bone window craniotomy, patients with hematoma clearance rate increased signiifcantly. The incidence of complications and mortality reduced effectively. Conclusion Cerebral hemorrhage in small bone window craniotomy treatment of hypertensive intracerebral hemorrhage disease has a signiifcant effect and advantage and can effectively restore patients'' quality of life.

脑微出血是一种脑小血管病变,是导致认知功能障碍的重要原因。本文在归纳总结现有文献的基础上,主要阐述了年龄、高血压、胆固醇水平、基因等危险因素与脑微出血的相关性的最新研究进展,并分析了脑微出血在神经血管疾病及药物治疗中的意义,以提高临床工作者对脑微出血的认识。

Cerebral microbleeds (CMB) are deifned as a kind of cerebral small vessel diseases, which is an important reason to cause cognitive dysfunction. Based on the published references, the latest research progresses of the correlation between risk factors including age, hypertension, cholesterol, gene, leukoaraiosis, and CMB were investigated. In addition, the significances of CMB in neural vascular disease and drug therapy were analyzed, which will help clinic workers to enhance the cognition of CMB.

探讨脑内微出血对自发性脑出血患者血肿进展的预测价值。方法:选取2010年7月至2013年7月我院收治的自发性脑出血患者110例,入院及72小时内复查CT和MR,根据有无血肿扩大将患者分为血肿扩大组和非血肿扩大组,并比较两组患者年龄、性别、血压,血肿量,血肿形态,有无糖尿病以及脑内微出血率进行比较,并通过回归分析确定影响脑出血患者血肿扩大的危险因素。结果:血肿扩大组与非血肿扩大组的性别比例、糖尿病比例、吸烟比例、心脏病比例、入院时舒张压和收缩压和72h后的舒张压和收缩压的差异均无统计学意义(P0.05),而血肿扩大组患者入院时的血肿体积、形态和脑内微出血的比例要明显高于非血肿扩大组的患者,且差异具有统计学意义(P0.05);Logistic回归模型分析,影响自发性脑出血血肿扩大的危险因素有脑内微出血、血肿体积和血肿形态。结论:自发性脑出血患者脑内微出血的存在和多少可作为血肿扩大的风险指标。

ObjectiveTo investigate the predictive value of cerebral microbleeds on hematoma in the patients with hypertensive ce-rebral hemorrhage. Method110 patients from July 2011 to July 2013 in our hospital were selected and the hematoma volume was de-tected by CT and MRI in 30min on admission, and blood pressure, disease history and genderdistribution were recorded.The patients were divided intohematoma expansion group and hematoma non- expansion groups according CT and MRI under review after 72h, the proportion of cerebral microbleeds was compared in two groups, as well as determined by regression analysis of patients with hy-pertensive cerebral hemorrhage expanding hematoma could predict risk factors. ResultsGender ratio, history of stroke ratio, the propor-tion of diabetes, smoking rates, the proportion of heart disease, diastolic and systolic blood pressure on admission and 72h diastolic and systolic blood pressure in two groups were not significantly different (P>0.05). The volume of ad

目的 探讨成年烟雾病患者脑微出血的分布模式,及其与颅内血管形态学的联系.方法 连续入选南京军区南京总医院2009年6月至2011年6月间首次经脑血管造影证实的成年烟雾病患者71例.对所有患者进行3.0T磁共振磁敏感成像检查并依照脑微出血病灶的分布区域分组.比较各组间包括年龄、性别、高血压、糖尿病、高脂血症、临床症状、起病时间以及血浆纤维蛋白原水平在内的基线危险因素,颅底烟雾血管铃木分级,后循环受累情况以及脉络膜前动脉-后交通动脉(AChA-PComA)分级等颅内血管形态学特点的关系.结果 于23例患者的25侧半球中检出30处脑微出血灶,其分布以深部侧脑室旁白质为主,占70.0％(21/30).根据脑微出血解剖定位标准将所有142侧半球分为无脑微出血组、侧脑室旁深部白质脑微出血组及其他部位脑微出血组.单因素分析提示年龄及AChA-PComA极度延长扩张的比例有可能与脑微出血病灶分布模式有关.进一步进行多因素回归分析显示:相对无脑微出血半球,AChA-PComA的极度延长扩张是深部侧脑室旁白质区域脑微出血病灶的影响因素之一(OR =3.090,95％CI1.050 ～ 9.140,P=0.041),而与其他部位的脑微出血病灶无明显关联(OR=1.680,95％CI0.390 ～7.190,P=0.483).结论 成年型烟雾病患者微出血病灶主要分布于深部侧脑室旁白质.这种特征性的分布模式可能与AChA-PComA的形态学变化有关.

Objective To investigate the relationship between cerebral microbleeds (CMBs) and morphology of intracranial arteries in adult patients with moyamoya disease.Methods Seventy-one adult patients with first catheter-based angiography confirmed moyamoya disease in Jinling Hospital from June 2009 to June 2011 were enrolled in the present study.Clinical baseline parameters in each patient include age,gender,history of hypertension,diabetes,hyperlipidemia,clinical symptoms,onset time and plasma fibrinogen were collated.All of the patients underwent susceptibility-weighted imaging of 3.0 T magnetic resonance imaging system to detect the CMBs foci.According to the angiographies,the relationship between distribution patterns of CMBs and the morphology of intracranial arteries including Suzuki stages of moyamoya vessels at the base of brain,posterior circulation involvement as well as the stages of dilation and extension of anterior choroidal artery-posterior communicating arteries (AChA-PComA) w