颅内动脉瘤破裂的临床危险因素分析

Clinical Risk Factors for Rupture of Intracranial Aneurysms

目的探讨颅内动脉瘤破裂的临床危险因素。方法采用病例-对照研究的方法,对颅内动脉瘤患者中破裂组和未破裂组的动脉瘤特征(是否多发、动脉瘤的位置、大小)做单因素和多因素分析。单因素分析采用χ2检验,以P<0.05为差异有统计学意义;多因素分析采用Logistic回归分析,基于偏最大似然估计的后退法(LR),入选标准取0.05,排除标准取0.10,以筛选颅内动脉瘤破裂的相关临床危险因素。结果单因素分析显示,颅内动脉瘤破裂组和未破裂组患者动脉瘤位置分布(主要为前交通动脉瘤、颈内动脉-后交通动脉瘤)及动脉瘤大小(瘤径≥7mm)比较,差异有统计学意义(P<0.05);多因素Logistic回归分析显示,动脉瘤位置〔前交通动脉瘤,P=0.027,OR=0.096,95%CI(0.012,0.770)〕及动脉瘤大小〔瘤径≥7 mm,P=0.001,OR=0.055,95%CI(0.011,0.285)〕与颅内动脉瘤破裂相关。结论位于前交通动脉及瘤径≥7 mm是颅内动脉瘤破裂的独立危险因素。

Objective To investigate clinical risk factors for the rupture of intracranial aneurysms.Methods Single factor and multiple factors analysis were conducted on aneurysm characteristics（multiple aneurysms,location and size of aneurysms） in ruptured intracranial aneurysms patients and unruptured intracranial aneurysms patients by using case-control study method.The single factor analysis adopted chi-square method,with P〈0.05 regarding as having statistical significance.Multiple factors analysis adopted Logistic regression analysis,and the Backward Stepwise（LR） method was used to screen possible risk factors.The inclusion criteria was 0.05 and the exclusion criteria was 0.10 for the selection of risk factors for the rupture of intracranial aneurysms.Results Single factor analysis showed that the locations（ACoA,ICA-PCoA） and sizes（aneurysm≥7 mm） of ruptured intracranial aneurysms patients and unruptured intracranial aneurysms patients had statistically significant differences（P〈0.05）.Multiple factors Logistic regression analysis showed that the locations（ACoA,P=0.027,OR=0.096,95%CI（0.012,0.770）） and sizes（aneurysm≥7 mm,P=0.001,OR=0.055,95%CI（0.011,0.285）） of aneurysms were related to the rupture of intracranial aneurysms.Conclusion ACoA and aneurysm≥7 mm are independent risk factors for the rupture of intracranial aneurysm.