中青年与老年颅内多发动脉瘤分布特征比较  

Comparison of the Distribution of Multiple Intracranial Aneurysms Between Young or Middle- aged Patients and Elderly Patients

作　　者：傅钢泽[1] 陈勇春[1] 毛丹丹[1] 陈永华[1] 杨运俊[1] 

机构地区：[1]温州医科大学附属第一医院放射科,浙江省温州市325000

出　　处：《中国全科医学》2015年第31期3828-3832,共5页Chinese General Practice

摘　　要：目的探讨中青年与老年颅内多发动脉瘤(MIA)的分布特征。方法选取2011年1月—2014年5月温州医科大学附属第一医院收治的MIA患者136例。以60岁为界,将所有患者分为中青年组(<60岁,n=58)和老年组(≥60岁,n=78)。比较两组MIA发生部位、破裂率及分布特征。结果 136例患者中共发现299枚动脉瘤,其中中青年组129枚(占43.1%),老年组170枚(占56.9%)。两组患者动脉瘤分布间差异有统计学意义(χ2=26.026,P=0.006);其中两组在后交通动脉、基底动脉分布间差异有统计学意义(P<0.05)。患者动脉瘤破裂率为64.0%(87/136);其中中青年组为74.1%(43/58),老年组为56.4%(44/78),两组间差异有统计学意义(χ2=4.536,P=0.033)。MIA跨越前后循环占14.7%(20/136);其中青年组占5.2%(3/58),老年组占21.8%(17/78),两组MIA前、后循环分布间差异有统计学意义(χ2=7.351,P=0.025)。MIA镜像分布占双侧分布的63.2%(48/76);其中中青年组镜像分布占46.6%(27/35),老年组镜像分布占26.9%(21/41),两组比较差异有统计学意义(χ2=5.612,P=0.018)。结论中青年MIA在后交通动脉分布明显多于老年MIA,并且中青年更好发镜像动脉瘤,以后交通动脉、大脑中动脉镜像动脉瘤常见。老年MIA趋向广泛分布,跨越前后循环分布较中青年更多见。认识MIA分布有助于提高检出率,为临床治疗提供帮助。Objective To investigate the difference in the distribution of multiple intracranial aneurysms （MIA） between young or middle - aged patients and elderly patients. Methods We enrolled 136 MIA patients who were admitted into the First Affiliated Hospital of Wenzhou Medical University from January 2011 to May 2014. With 60 years old as the boundary, the subjects were divided into two groups： young or middle -aged group （ 〈60, n =58） and elderly group （ ≥60, n =78）. Comparison was made between the two groups in the site, rupture rate and distribution feature of MIA. Results A total of 299 aneurysms were found in the 136 patients, among which 129 （43.1%） were of young or middle -aged group and 170 （56. 9% ） were of elderly group. The two groups were significantly different in the distribution of aneurysms （χ2 = 26. 026, P = 0. 006） ; the two groups were significantly different （ P 〈 0. 05 ） in the distribution of aneurysms in posterior communicating artery and basilar artery. The general aneurysm rupture rate was 64. 0% （ 87/136 ） ; the aneurysm rupture rate was 74. 1% （43/58） for young or middle -aged group and was 56.4% （44/78） for elderly group, with significant difference between the two groups （ χ2 = 4. 536, P = 0. 033 ） . The patients with MIA spaning both anterior and posterior circulation accounted for 14. 7% （20/136）, and the ratio was 5.2% （3/58） for young or middle - aged group and 21.8% （17/78） for elderly group, with significant differences in MIA distribution in anterior and posterior circulation （χ2 = 7. 351, P =0. 025） . Mirror image aneurysms took up 63.2% （48/76） in bilateral distribution, and the ratio was 46. 6% （27/35） for young and middle - aged group and 26.9% （21/41） for elderly group, with significant differences between the two groups （χ2 = 5. 612, P =0. 018） . Conclusion More aneurysms in posterior communicating artery are detected in young or middle - aged people than in the elderly, and mirror image ane

关 键 词：颅内动脉瘤 青年人 中年人 老年人 疾病特征 

分 类 号：R651.122[医药卫生—外科学]