影响介入治疗颅内动脉瘤预后的多因素Logistic分析  

Multivariate Analysis of the Associated Factors Influencing the Outcome for Endovascular Treatment of Intracranial Aneurysms

作　　者：姜大景[1] 汪华[1] 向明清[1] 郭才华[1] 姜振威[1] 胡婷婷[1] 

机构地区：[1]长江大学医学院附属荆州市第一人民医院,湖北荆州434000

出　　处：《中西医结合心脑血管病杂志》2016年第12期1328-1331,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨影响介入治疗颅内动脉瘤预后的危险因素。方法回顾性分析2010年3月—2014年2月在我院神经外科经介入治疗的152例颅内动脉瘤病人的临床资料,包括Hunt-Hess分级、性别、年龄、高血压病、糖尿病、动脉瘤位置、动脉瘤多次破裂、瘤颈宽度、多发性动脉瘤、基础病、瘤体大小、自发性蛛网膜下腔出血改良分级(CTFisher分级)12种可能影响因素。采用格拉斯哥预后量表(GOS)评分,评估10个月后各个病人的预后情况,并对可能的影响预后因素作单因素和多因素Logistic分析。结果单因素分析显示,Hunt-Hess分级、高血压、动脉瘤位置、动脉瘤多次破裂、多发性动脉瘤、基础病对介入手术的预后有影响,差异有统计学意义(P<0.05)。多因素分析显示,Hunt-Hess分级(OR=19.375,P<0.05)、高血压(OR=6.862,P<0.05)、动脉瘤多次破裂(OR=6.573,P<0.05)、多发性动脉瘤(OR=8.449,P<0.05)为影响介入治疗预后的重要因素。结论 Hunt-Hess分级、高血压、动脉瘤多次破裂、多发性动脉瘤是影响预介入治疗颅内血管瘤预后的重要独立危险因素。Objective To study risk factors influencing the Outcome for endovascular treatment of intracranial aneurysms.Methods The clinical data of 152 patients with intracranial aneurysm treated with craniotomy in the Department of Neurosurgery form March2010 to February 2014 were analyzed retrospectively.The factors include Hunt Hess grade, sex, age, hypertension, diabetes, loca -tion, history of repeated rupture, and so on.A total of 12 potential factors associated with poor outcome of endovascular treatment ofintracranial aneurysms were evaluated by univariate analysis and multivariate Logistic regression analysis.Results The univariate a -nalysis showed that Hunt Hess grade, hypertension, location, repeated rupture, multiple aneurysms, underlying diseases were signif -icantly different between patients with poor outcome and good outcome after endovascular treatment （ P 〈0.05） .Results Logisticregression analysis showed that Hunt Hess grade （ OR =19.375, P 〈0.05） , hypertension （ OR =6.862, P 〈0.05） ,repeated rup -ture （ OR =6.573, P 〈0.05） ,multiple aneurysms （ OR =8.449, P 〈0.05）were independent risk factor for endovascular treatmentof intracranial aneurysms.Conclusion Hunt Hess grade, hypertension, repeated rupture, multiple aneurysms were independent riskfactor for endovascular treatment of intracranial aneurysms.

关 键 词：颅内动脉瘤 介入治疗 预后 危险因素 格拉斯哥预后量表 

分 类 号：R743[医药卫生—神经病学与精神病学]