后交通动脉动脉瘤破裂的危险因素分析  

Analyses of risk factors for posterior communicating artery aneurysm rupture

作　　者：崔岩[1] 张明铭[1] 蒋宇钢[1] 

机构地区：[1]中南大学湘雅二医院神经外科,长沙410000

出　　处：《中华神经外科杂志》2015年第6期563-567,共5页Chinese Journal of Neurosurgery

摘　　要：目的 从临床与形态学方面分析后交通动脉动脉瘤破裂出血的危险因素.方法 回顾性分析2011年1月至2013年12月连续收治的单发后交通动脉动脉瘤病例（185例）,并针临床资料和影像学特征行单因素分析与多元Logistic回归分析.结果 单因素分析提示后交通动脉动脉瘤破裂率在高血压病史（x2=23.013,P=0.000）、瘤体长径/瘤颈宽度（aspect ratio,AR）≥1.5（x2=8.492,P =0.004）、不同瘤顶指向（x2=15.057,P =0.020）、子瘤（x2=18.952,P=0.000）的区组间差异有统计学意义.多因素Logistic回归分析结果为高血压病史（OR=13.240,P=0.000）、存在子瘤（OR=12.933,P=0.001）、年龄低于60岁（OR=3.766,P=0.010）以及AR值≥1.5（OR=4.997,P=0.001）、瘤顶指向后下外（OR=7.584,P=0.038）.结论 高血压病史、存在子瘤、年龄低于60岁、AR值≥1.5和瘤顶指向后下外为后交通动脉动脉瘤破裂的危险因素.Objective To analyze the risk factors for posterior communicating artery （PCoA） aneurysm rupture from the clinical and morphological aspects.Methods Consecutive patients with single PCoA aneurysm admitted to hospital from January 2011 to December 2013 were analyzed retrospectively.The clinical data and imaging characteristics were analyzed with univariate analysis and multivariate logistic regression analysis.Results Univariate analysis indicated that there were significant differences in the rupture rate of PCoA aneurysms in the history of hypertension （x2 =23.013,P =0.000）,aspect ratio （AR） ≥ 1.5 （x2 =8.492,P =0.004）,directions of different aneurysm tops （x2 =15.057,P =0.002）,and aneurysm blebs （x2 =18.952,P =0.000） between the two groups.The results of multivariate logistic regression analysis were the history of hypertension （OR,13.240,P =0.000）,presence of aneurysm blebs （OR,12.933,P =0.001）,age less than 60 years （OR,3.766,P =0.010）,AR ≥ 1.5 （OR =4.997,P =0.001）,and posterior-inferior-lateral directions of aneurysm tops （OR,7.584,P =0.038）.Conclusion The history of hypertension,presence of aneurysm blebs,age less than 60 years,AR ≥ 1.5 and posterior-inferior-lateral directions of aneurysm tops were the risk factors for PCoA aneurysm rupture.

关 键 词：颅内动脉瘤 危险因素 后交通动脉 

分 类 号：R743[医药卫生—神经病学与精神病学]