30例伴有颅内血管狭窄的动脉瘤患者风险因素相关分析

Correlation analysis on risk factors in 30 cases of intracranial vascular stenosis artery aneurysm

目的分析伴有颅内血管多发狭窄的动脉瘤患者的影像学特点及其相关危险因素,评价因脑血管狭窄导致血液流体力学变化对动脉瘤发生的影响。方法回顾性分析2007年1月至2012年5年北京军区二五一医院神经内科收治的因缺血性脑血管疾病住院治疗,且经CTA及DSA确诊伴有颅内动脉多发狭窄的动脉瘤患者30例,设为观察组;以同期神经外科收治的不伴颅内、外动脉狭窄的30例动脉瘤患者设为对照组,比较两组患者性别、发病年龄、动脉瘤数,是否吸烟,合并高血压、糖尿病、高脂血症,以及是否伴有颅外段颈动脉斑块、缺血性脑卒中及是否合并脑动脉发育异常。通过Logistic单因素及多因素相关分析评价动脉瘤发生与动脉粥样硬化性狭窄所致血流动力学改变关系。结果观察组患者中,以囊性多发动脉瘤为主,动脉瘤最多可达4个。年龄多大于60岁,多数伴发高血压、糖尿病、高脂血症,脑卒中、颈动脉粥样斑块及颅内段动脉多发狭窄在本组患者中多见。在有严重狭窄的颅内动脉发生动脉瘤者居多,性别差异不大。而对照组多为年轻患者,动脉瘤以单发者居多,不伴颅内动脉多发狭窄,颈动脉斑块及脑卒中发生率偏低,部分有吸烟、高脂血症及高血压等。两组患者进行Logistic回归分析,缺血性脑卒中、脑动脉发育异常及颅外段血管粥样斑块有显著相关性(P<0.05)。结论动脉瘤发生与动脉粥样硬化性狭窄有关,其已经成为导致老年患者动脉瘤形成的重要因素,应引起关注并早期预防治疗。

Objective To analyze the imageological characteristics of intracranial vascular multiple stenosis aneurysms and to e- valuate the influence of cerebral vascular stenosis caused hemodynamic change on the aneurysm occurrence. Methods The clinical data of 30 inpatients with intracranial arterial muttiple stenosis aneurysms diagnosed by CTA and DSA,who were hospitalized due to ischemic cerebrovascular disease in the neurology department of 251 Hospital of Beijing Military Region from January 2007 to May 2012, were retrospectively analyzed and taken as the observation group; contemporaneous 30 cases of aneurysm without in- tracranial and extracranial arterial stenosis admitted to the neurosurgery department were taken as the control group. The gender, age of onset, number of aneurysms, whether or not complicating hypertension, diabetes, smoking, hyperlipemia, plaque of extracrani- al carotid artery,ischemic stroke and cerebral arterial abnormal development were compared between the two groups. The Logistic single factor and multi-factor correlation analysis was adopted to evaluate the correlation between the aneurysm occurrence with the hemodynamic changes caused by atherosclerotic stenosis. Results Cystic multiple aneurysms were common in the observation group, which was up to 4 in number, the age was more than 60 years, the majority was complicated by hypertension, diabetes, hyper- lipemia,cerebral stroke, plaque of extracranial carotid artery and intracranial arterial multiple stenosis were common, Aneurysms mostly occurred in intracranial artery with severe stenosis. The gender differences were unobvious. The control group was domina- ted by young patients. Single aneurysm was more common without intracranial artery multiple stenosis. The occurrence rate of ca- rotid arterial plaque and cerebral stroke was lower. The partial patients had smoking,hyperlipidemia and hypertension. The Logistic regression analysis between the two groups showed that ischemic stroke,cerebral arterial development abnormality and atheroscle- rosis plaque of extracranial carotid artery had significant correlation. Conclusion The aneurysm occurrence is related with cerebral arterial atherosclerotic stenosis,which becomes the important factor leading to aneurysm formation and should arouse attention to conduct early diagnosis and early treatment.