脑血管畸形破裂出血的影响因素分析  

Influencing factors of rupture and bleeding in patients with cerebral vascular malformations

作　　者：杨建平[1] 彭秋平[1] 胡欣[1] 

机构地区：[1]江西省吉安市中心人民医院神经外科,343000

出　　处：《中华神经医学杂志》2012年第11期1152-1155,共4页Chinese Journal of Neuromedicine

摘　　要：目的分析脑血管畸形患者发生出血的影响因素，为防治出血的发生提供诊治依据。方法回顾性分析吉安市中心人民医院神经外科自2002年1月至2012年1月收治的126例脑血管畸形患者的影像学资料，根据其是否发生出血分为出血组和未出血组，结合畸形血管团大小、位置，引流静脉方向、数目，供血动脉位置，合并动脉瘤数目、与畸形血管团位置关系，有无合并瘤样变等因素进行多因素Logistic回归分析和受试者工作特征（ROC）曲线分析，并比较各影响因素的曲线下面积（AUCl，评价各影响因素对脑血管畸形破裂出血的预测价值。结果单因素分析显示畸形血管团大小、引流静脉方向、供血动脉位置、合并动脉瘤数目、合并瘤样变、与畸形血管团位置关系在出血组和未出血组问比较差异有统计学意义（P〈0．05）。多因素Logistic回归分析及ROC曲线分析显示畸形血管团（OR=0．218，P=-0．012）、引流静脉方向（OR=8．023，P=0．004）、合并动脉瘤（OR=6．539，P=-0．029）是脑血管畸形患者发生出血的影响因素，AUC值分别为0．674、0．897、0．729。结论畸形血管团大是患者发生出血的保护因素．深部静脉引流、合并动脉瘤是患者发生出血的危险因素；引流静脉方向对患者发生出血的预测价值最高。Objective To analyze the influencing factors of rupture and bleeding in patients with cerebral vascular malformations, and provide scientific basis for preventing and treating the bleeding. Methods The neuroimaging data of 126 patients with cerebral vascular malformations, admitted to our hospital from January 2002 to January 2012, were retrospectively analyzed; these patients were divided into bleeding group and non-bleeding group according to the occurrence of hemorrhage. Occurrence of hemorrhage being the dependent variables, multivariate logistic regression and receiver operating characteristic （ROC） curve analyses were used to compare the areas under the curve （AUC） of influence factors so as to forecast the value of influence factors in cerebral vascular malformation rupture. Results Univariate analysis showed that significant differences on sizes and locations of vascular malformation groups, venous drainage direction, location of supply blood and number of combined aneurysms were noted between the two groups （P〈0.05）. Multivariate analysis showed that vascular malformation groups （OR=0.218, AUC=0.674）, venous drainage direction （OR=8.023, AUC=0.897） and combined aneurysms （OR=6.539, AUC=0.729） were the influencing factors of bleeding. Conclusion Large vascular malformation groups are protective factors of hemorrhage, deep venous drainage and combined aneurysms are risk factors of hemorrhage.

关 键 词：脑血管畸形 出血 影响因素 

分 类 号：R743.4[医药卫生—神经病学与精神病学]