Effect of Apolipoprotein E on the Prognosis of Patients With Intracerebral Hemorrhage

The Affiliated Hospital Of Guizhou Medical University330 enrolled

Overview

The purpose of this observational study was to compare perihematomal edema and short-term prognosis in patients with intracerebral hemorrhage carrying the APOE-ε3 and APOE-ε4 genes. The main questions it aims to answer are: * Exploring whether patients carrying the ApoE-ε4 gene have more perifocal perihematomal edema after intracerebral hemorrhage than patients with the ApoE-ε3 gene. * ApoEε4 gene has worse short-term prognosis than ApoEε3 gene in intracerebral hemorrhage patients. All the patients in this study received the same medications based on the guidelines for the management of hypertensive intracerebral hemorrhage.Some ICH patients were evaluated for Stereotactic minimally invasive surgery (sMIS) treatment by two experienced neurosurgeons.

Study Type

OBSERVATIONAL

Enrollment

330

Conditions

Intracerebral Hemorrhage

Interventions

Non-enhanced CT scan、Nuclear Magnetic Resonance (MRI)DIAGNOSTIC_TEST

Non-surgical patients were followed up by CT on days 1 and 5-7 after ICH, and by CT or MRI on day 5-7. Surgical patients were followed up by CT before surgery and then transferred to the operating room. The first postoperative follow-up CT scan was performed on the second day after surgery, and the second postoperative CT scan was performed on the third day after surgery. Some patients need a third or even a fourth CT follow-up after surgery. The CT scan can be repeated at any time if the patient has neurologic deterioration.

Eligibility

Sex: ALL

Medical Language ↔ Plain English

Inclusion Criteria: * Relevant diagnosis of supratentorial ICH was confirmed through unenhanced CT scanning. * Patients were distinguished based on venous blood collection, with the presence of the ApoE-ε4 (ε2/ε4, ε3/ε4, ε4/ε4) gene (ApoE-ε4 genotype) and patients harboring the ApoE-ε3 (ε3/ε3) gene (non-ApoE-ε4 genotype). Exclusion Criteria: * Patients with infratentorial ICH. * Patients with ApoE-ε2 (ε2/ε2) based on venous blood collections. * Younger than 18 years of age. * ICH caused by trauma, anticoagulation therapy, or antiplatelet therapy. * Patients admitted to the hospital with diseases that might impact inflammatory responses, such as infective meningitis and systemic infections. * Patients with previous residual neurological deficits following a stroke. * Patients with combined tumours, severe liver and kidney dysfunction, cardiac insufficiency.

Outcomes

Primary Outcomes

One month after ICH

Telephone follow-up by experienced neurologist.Defining a modified Rankin Scale (mRS) score of 0-3 at discharge was considered to be a good prognosis. If the mRS score was \>3, the prognosis was considered poor.

Time frame: A maximum of 1 month was assessed from the date of randomization to the date of the first record of progression or death from any cause, whichever came first.

Volume of perihematoma edema

Calculation of perihematoma edema volume after ICH by non-enhanced CT scan.

Time frame: Within 24 hours of ICH

Changes in the volume of perihematoma edema

Calculation of perihematoma edema volume after ICH by non-enhanced CT scan.

Time frame: Days 5-7 after ICH

Secondary Outcomes

Venous blood indicators

Indicators of venous blood leukocytes, neutrophils and blood lymphocytes (10\^9/L) were analysed.

Time frame: Within 24 hours of the onset of ICH