论文部分内容阅读
目的探讨前交通动脉瘤(ACo A)破裂的临床危险因素及动脉瘤形态学特征对动脉瘤破裂的影响。方法收集2013年1月~2016年11月在昆明医科大学第一附属医院就诊的138例ACo A患者,所有患者均行全脑血管造影(DSA)或颅脑磁共振血管成像(MRA)或CT血管成像(CTA)检查,入组108例。采用单因素及多因素Logistic回归方法分析患者的临床及ACo A形态学资料。结果 ACo A破裂与未破裂患者相比,血糖(P=0.038)、收缩压(P=0.036)、舒张压(P=0.046)及动脉瘤长度(P=0.013)、宽度(P=0.037)、瘤颈宽度(P=0.014)、A1/A2夹角≤100°(P=0.026)、动脉瘤有子囊(P=0.0006)之间的差异有统计学意义。多因素Logistic回归分析显示,血糖(OR 4.19,95%CI 1.615~10.899,P=0.003)、动脉瘤瘤颈宽度(OR2.14,95%CI 1.201~3.819,P=0.009)、动脉瘤有子囊(OR 12.94,95%CI 2.339~71.604,P=0.003)是ACo A破裂的独立危险因素。ROC曲线显示,瘤颈宽度的最佳预测值为3.79 mm(曲线下面积0.66,95%CI 0.534~0.786);A1-A2夹角最佳预测值为<98°(曲线下面积0.619,95%CI 0.482~0.755)。结论 ACo A瘤颈宽度>3.79 mm、是否有子囊,以及A1-A2夹角<98°为ACo A破裂的独立危险因素。
Objective To investigate the clinical risk factors of rupture of anterior communicating artery aneurysm (ACoA) and the morphological features of aneurysms on aneurysm rupture. Methods A total of 138 ACoA patients were enrolled in the First Affiliated Hospital of Kunming Medical University from January 2013 to November 2016. All patients underwent total cerebral angiography (DSA) or cranial magnetic resonance angiography (MRA) or CT Vascular imaging (CTA) examination, enrolled 108 cases. Univariate and multivariate Logistic regression analysis of clinical and ACo A morphological data. Results Blood glucose (P = 0.038), systolic blood pressure (P = 0.036), diastolic blood pressure (P = 0.046) and aneurysm length (P = 0.013) and breadth (P = 0.037) The difference of tumor neck width (P = 0.014), A1 / A2 angle ≤100 ° (P = 0.026) and aneurysm ascus (P = 0.0006) was statistically significant. Multivariate logistic regression analysis showed that there was no significant difference in the blood sugar (OR 4.19,95% CI 1.615-10.899, P = 0.003), aneurysm neck width (OR2.14,95% CI 1.201-3.819, P = 0.009) (OR 12.94, 95% CI 2.339 ~ 71.604, P = 0.003) were independent risk factors for ACo A rupture. The ROC curve showed that the optimal prediction value of nodule width was 3.79 mm (area under the curve 0.66, 95% CI 0.534-0.786); the best predicted value of A1-A2 included angle was <98 ° (area under the curve 0.619, 95% CI 0.482 ~ 0.755). Conclusions The neck width of ACoA> 3.79 mm, the presence of ascus, and the angle of A1-A2 <98 ° are independent risk factors for ACo A rupture.