未破裂颅内动脉瘤287例患者的危险因素分析  

Analysis of risk factors in 287 patients with unruptured intracranial aneurysms

作　　者：代书君 王瑜龙 董秀芳 许蕾[1] Dai Shujun;Wang Yulong;Dong Xiufang;Xu Lei(Department of Neurology,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院神经内科,石家庄050000 [2]邢台市第一医院

出　　处：《脑与神经疾病杂志》2023年第2期104-109,共6页Journal of Brain and Nervous Diseases

摘　　要：目的 探讨影响未破裂颅内动脉瘤(IA)发生、临床症状的展现相关的危险因素。方法本研究为回顾性病历-对照研究,其中病历组287例、对照组300例,除外了既往发生过蛛网膜下腔出血(SAH)或接受过动脉瘤夹闭、动脉瘤血管内栓塞治疗的患者。病例组为经MRA、CTA和/或颅脑DSA检查发现存在1个或多个IA患者。对照组经MRA、CTA和/或DSA检查未发现IA的患者。收集研究对象的基本信息、体格检查、既往病史、血生化指标、影像学参数等信息,并评估动脉瘤的大小与位置等形态学参数。结果①女性、年龄、吸烟、高血压病、体质量、高同型半胱氨酸(hyperhomocysteine Hhcy)、脂蛋白(a)[lipoprotein](a),Lp(a)水平增高为IA发生的危险因素。经多因素校正后显示,女性、年龄、吸烟、高血压病、Hhcy为影响IA发生的独立危险因素;②建立了IA发生的风险模型,该模型ROC曲线下面积为0.783(0.745,0.820),具有良好的诊断效能;③年龄、吸烟、高血压病、Hhcy、Lp(a)水平增高是影响有症状的未破裂IA形成的独立危险因素。结论IA发生的独立危险因素为女性、年龄、吸烟、高血压病、Hhcy,其作用由大到小依次为Hhcy>吸烟>高血压病>年龄>女性。影响未破裂IA表现出临床症状的独立危险因素是年龄、吸烟、高血压病、Hhcy、Lp(a)水平增高。ObjectiveTo explore the related risk factors affecting the occurrence and symptomatic presentations of unruptured intracranial aneurysms(IA).Methods This study is a retrospective case-control study,including 287 cases in the patient group and 300 cases in the control group,except those who had subarachnoid hemorrhage(SAH)or received IA clipping,endovascular embolization in the past.For the patient group,one or more IA were detected by MRA,CTA,and/or cerebral DSA,For the control group no IA was found by MRA,CTA and/or cerebral DSA.The basic information,physical examination,past medical history,blood biochemistry indicators,imaging parameters and other information of the subjects were collected.The size and location of the aneurysms and the related morphological parameters were evaluated.Results 1.Female,age,smoking,hypertension,BMI,Hhcy,elevated levels of lipoprotein(a)[Lp(a)]were risk factors for the formation of IA.After multivariate adjustment,female,age,smoking,hypertension and Hhcy were independent risk factors for the occurrence of IA.2.A risk model for the occurrence of IA was established.The area of the model under the R0C curve was 0.783(0.745,0.820),with good diagnostic efficacy.3.Age,smoking,hypertension,Hhcy and elevated levels of Lp(a)were independent risk factors for the formation of symptomatic unruptured IA.Conclusion The independent risk factors for the occurrence of IA were female,age,smoking,hypertension and Hhcy,and their roles in descending order were Hhcy>smoking>hypertension>age>female,.The independent risk factors for clinical symptomatic unruptured IA were age,smoking,hypertension,Hhcy and elevated levels of Lp(a).

关 键 词：颅内动脉瘤 未破裂颅内动脉瘤 有症状的未破裂颅内动脉瘤 无症状的未破裂颅内动脉瘤 同型半胱氨酸 脂蛋白(a) 

分 类 号：R743.32[医药卫生—神经病学与精神病学]