脑动静脉畸形出血危险因素的分析与评价

Analysis of risk factors in predicting hemorrhage of cerebral arteriovenous malformations.

目的:探讨与脑动静脉畸形(AVM)出血相关的临床及血管影像学特征,以期对脑 AVM 的出血倾向作出评价和预测。方法:应用 Cox 回归模型,对59例脑 AVM 进行出血危险因素的单因素及多因素分析.结果:59例脑 AVM 中,观察期内出血48例(占81.4%),年平均出血率为2.3%;病灶大小、供应动脉支数以及引流静脉支数是决定脑 AVM 出血倾向最重要的危险因素;小型 AVM、多支动脉供应的 AVM 以及仅有单支静脉引流的 AVM 最易破裂出血。结论:建议脑血管造影时着重对此三项指标进行描述;对于出血风险较大的脑 AVM 应及早治疗。

Objective:To determine whether there are any specific clinical and radiographic characteristics to predict the risk of bleeding in cerebral arteriovenous malformation(AVM) patients.Methods:We reviewed over the clinical his- tories and cerebral angiograms of 59 AVM patients.Univariate and multivariate analysis were performed with the Cox regression model to identify independent risk factors.Results:Of 59 AVM patients,48(81.4%)had well-documented histories of intracranial hemorrhage.The overall annual rate of hemorrhage was 2.30%;Three significant risk factors for hemorrhage were shown:the size of the AVM,number of feeding arteries and number of draining veins.AVM of small size,with multiple arterial supply and single drainage vein were more potent to hemorrhage.Conclusion:we sug- gest that these inparameters should be described in detail in angiographic report and patients with high hemorrhagic risk AVM should be treated as early as possible.