基于临床特征、CT形态学分析颅内微小动脉瘤破裂的风险因素  

Analysis of Risk Factors for Rupture of Intracranial Microaneurysms Based on Clinical Features and CT Morphology

作　　者：龙波 陈偶英[1] 杨红秀[2] 朱娥 Long Bo;Chen Ouying;Yang Hongxiu;Zhu E(School of Nursing,Hunan University of Chinese Medicine,Changsha 410208,China;Department of Critical Care Medicine,Hunan Provincial Brain Hospital·Hunan Second People's Hospital,Changsha 410000,China;Department of Neurology,Hunan Provincial Brain Hospital·Hunan Second People's Hospital,Changsha 410000,China)

机构地区：[1]湖南中医药大学护理学院,长沙410208 [2]湖南省脑科医院/湖南省第二人民医院重症医学科,长沙410000 [3]湖南省脑科医院/湖南省第二人民医院神经内科,长沙410000

出　　处：《成都医学院学报》2025年第1期74-77,共4页Journal of Chengdu Medical College

基　　金：湖南省卫生健康委员会科研计划项目(No:D202314057443)。

摘　　要：目的探讨颅内微小动脉瘤(IMA)破裂的风险因素,并构建风险因素预测模型,探索其预测价值。方法回顾性选取2022年3月至2024年2月湖南省脑科医院/湖南省第二人民医院收治的102例IMA患者为研究对象,根据电子计算机断层扫描血管造影(CTA)、数字减影血管造影(DSA)或手术结果判断是否发生IMA破裂,并根据上述检查结果将所选患者分为破裂组(50例)和未破裂组(52例)。统计所选患者的临床、CT形态学特征及实验室检测结果,利用单因素和多因素Logistic回归分析IMA破裂的影响因素,绘制受试者工作特征曲线(ROC),获取曲线下面积(AUC),分析风险因素预测模型对IMA破裂的预测价值。结果破裂组和未破裂组动脉瘤尺寸比(SR)、纵横比(AR)、入射角(FA)及血清镁(Mg)、钙(Ca)水平比较,差异有统计学意义(P<0.05)。Logistic回归分析结果显示,SR大(OR=1.067)、AR大(OR=1.076)、FA大(OR=1.093)、血清Mg水平低(OR=1.084)、血清Ca水平低(OR=1.074)是IMA破裂的独立危险因素(P<0.05)。ROC分析结果显示,预测模型预测IMA破裂的AUC值为0.912,敏感度为76.00%,特异度为90.38%。结论IMA破裂可能与SR、AR、FA大及血清Mg、Ca低有关,据此建立的预测模型预测价值较好。Objective To explore the risk factors for rupture of intracranial microaneurysms(IMA),construct a risk factor prediction model and explore its predictive value.Methods A total of 102 patients with IMA admitted to Hunan Second People's Hospital(Hunan Provincial Brain Hospital)from March 2022 to February 2024 were retrospectively selected.Whether rupture of IMA occurred was determined based on computed tomography angiography(CTA),digital subtraction angiography(DSA),or surgical results.And the included patients were divided into a rupture group(n=50)and an unruptured group(n=52)according to the results of the above examinations.The clinical and CT morphological characteristics,and the laboratory test results of the selected patients were collected and analyzed.The influencing factors of IMA rupture were analyzed using univariate and multivariate Logistic regression.Receiver operating characteristic(ROC)curve was plotted to obtain the area under the curve(AUC).And the predictive value of the risk factor prediction model for IMA rupture was analyzed.Results There were significant differences in size ratio(SR),aspect ratio(AR),inflow angle(FA)and serum magnesium(Mg)and calcium(Ca)levels between the two groups(P<0.05).Logistic regression analysis showed that large SR(OR=1.067),large AR(OR=1.076),large FA(OR=1.093),low serum Mg level(OR=1.084),and low serum Ca level(OR=1.074)were independent risk factors for IMA rupture(P<0.05).ROC analysis showed that the predictive model predicted IMA rupture with an AUC value of 0.912,a sensitivity of 76.00%,and a specificity of 90.38%.Conclusion IMA rupture might be associated with large SR,AR and FA,and low serum Mg and Ca,and the predictive model based on this has a good predictive value.

关 键 词：颅内微小动脉瘤 破裂 临床特征 电子计算机断层扫描 风险因素 预测价值 

分 类 号：R743[医药卫生—神经病学与精神病学]