脑动静脉畸形出血相关因素分析

Analysis of relevant factors of cerebral arterlovenous malformation with hemorrhage

目的通过数字减影血管造影（DSa）检测脑动静脉畸形（AVM）血管构筑特征，分析探讨脑AVM合并出血的相关影响因素，以期预测脑AVM出血的危险性。方法对2004至2010年山东大学第二医院的87例脑AVM患者行全脑血管造影。采用单因素和多因素Logistic回顾性分析，对畸形血管团的大小、位置、供血动脉类型、引流静脉数目、引流静脉路径、有无合并动脉瘤、有无合并静脉瘤等因素与畸形血管团破裂出血的关系进行了分析。结果单因素分析表明AVM大小、位置、供应动脉类型、引流静脉支数、是否合并动脉瘤是畸形血管团破裂出血的危险因素。多因素Logistic分析发现畸形血管团破裂出血独立危险因素是AVM大小、引流静脉支数、合并动脉瘤。结论脑AVM大小、部位、供血动脉的类型、引流静脉的数目及合并动脉瘤与脑AVM出血密切相关。

Objective To explore the influencing factors of bleeding in the patients with cerebral arteriovenous malformation （AVM） through observing its angioarchitecture with cerebral digital subtraction angiography （DSA） so as to decipher its hemorrhagic risks. Methods A total of 87 cases of cerebral AVM during the period of 2004 -2010 underwent cerebral angiography by digital subtraction angiography. The relationships between bleeding and such factors as the site and size of masses of AVM, the type and site of supplying arteries, the number and pathway of venous drainage, the relationships between AVM and aneurysm in terms of location and venous tumor were determined by univariate analyses and binary Logistic regression with SPSS 18. 0. Results Univariate analysis indicated that such factors as the site and size of masses, the type and site of supplying arteries, the number venous drainage, the relationships between AVM and aneurysm were positively correlated with hemorrhagic presentation. When stepwise multiple Logistic regression analysis was employed, only the size of AVM, the number of venous drainage and aneurysm were the independent predictors of hemorrhagic presentation. Conclusion The size of masses of AVM, the number of venous drainage and aneurysm are the strong risk predictors for AVM hemorrhage.