颈内动脉后交通动脉小动脉瘤破裂危险因素分析  

Analysis of risk factors related to rupture of small(diameter ≤5 mm) posterior communicating artery aneurysms

作　　者：张莹[1] 荆林凯 张倩倩[1] 刘健[1] 张义森[1] 王坤[1] 穆士卿[1] 杨新健[1] 

机构地区：[1]北京市神经外科研究所/首都医科大学附属北京天坛医院神经介入科,北京100050

出　　处：《中国临床神经外科杂志》2016年第3期138-140,共3页Chinese Journal of Clinical Neurosurgery

基　　金：国家自然科学基金(81301003;81371315;81171079;81220108007);首都卫生发展科研专项重点攻关项目(2014-1-1071);北京市神经外科研究所青年基金(2014-001)

摘　　要：目的探讨颈内动脉后交通动脉小动脉瘤（直径≤5 mm）破裂出血的危险因素。方法回顾性分析83例颈内动脉后交通动脉小动脉瘤（破裂动脉瘤47例,未破裂动脉瘤36例）的临床资料、3D-DSA影像参数和血流动力学参数,采用多元Logistic回归分析检验危险因素。结果动脉瘤呈分叉型（OR=3.368;95%CI为1.124～10.094;P=0.030）和不规则形（OR=5.706;95%CI为1.415～23.011;P=0.014）是颈内动脉后交通动脉小动脉瘤破裂的独立危险因素;而壁面切应力与动脉瘤破裂呈负相关（OR=0.053;95%CI为0.005～0.520;P=0.012）。结论分叉型形状、不规则型形状和低壁面切应力是颈内动脉后交通动脉小动脉瘤破裂的独立危险因子。Objective To analyze risk factors related to the rupture of small（diameter≤5 mm） posterior communicating artery（PCo A） aneurysms.Methods Eighty-three consecutive patients with small PCo A aneurysms, of whom, 47 had ruptured aneurysms and 36 unruptured, were retrospectively collected. The risk factors possibly related to the rupture of small PCo A aneurysms including the patients＇ age, sex, individual and disease history, morphologic parameters derived from 3D-DSA images and hemodynamic parameterswere analyzed by univariate analysis and multivariate logistic regression analysis.Results The univariate analysis showed that the factorsrelated to the rupture of the aneurysms included the patients＇ age, five morphological factors（bifurcation type, irregular shape, size,aspect ratio and size ratio）, and five hemodynamic factors（wall shear stress, oscillatory shear index, area under low wall shear stress,complex and unstable flow pattern）. Stepwise multivariate logistic regression analysis showed that the independent possible risk factor srelated to the rupture of the aneurysms included bifurcation type（OR 3.368, P=0.030）, irregular shape（OR 5.706, P=0.014） and lower wall shear stress（OR 0.053, P=0.012）.ConclusionIt is suggested that bifurcation type, irregular shape and lower wall shear stress were the risk factors of small PCo A aneurysm rupture

关 键 词：颅内动脉瘤 后交通动脉 破裂 危险因素 血流动力学 

分 类 号：R743.9[医药卫生—神经病学与精神病学]