硬脑膜动静脉瘘侵袭性表现的危险因素分析

Risk factors of aggressive dural arteriovenous fistula

目的目前除了合并皮层静脉引流被认为是硬脑膜动静脉瘘(DAVF)的侵袭性表现的高危因素之外,尚无其他危险因素被大家所公认。本研究的目的在于通过单因素和多因素分析,阐明DAVF侵袭性表现的危险因素。方法回顾分析2007年1月至2012年12月第二军医大学长海医院临床神经医学中心收治的190例DAVF患者。其中侵袭性表现112例,非侵袭性表现78例。收集临床和影像学资料,提取人口学特征、临床表现类型、血管构筑学特征等参数,对比不同表现DAVF在上述参数上的差异,并进行Logistic回归分析。结果 Logistic回归分析发现侵袭性表现发病的独立危险因素为瘘口部位位于大静脉窦区(P<0.001),引流方式为Borden II型(P<0.001)和III型(P=0.002)。结论瘘口位于大静脉窦区,引流方式为Borden II型和III型是DAVF发生侵袭性表现的独立危险因素。

Objective The clinical manifestations of dural arteriovenous fistulas （DAVF） can be divided into non-aggressive and aggressive performance. To date, no other factors have been recognized as risk factors for aggressive manifestation except for cortical venous drainage. It is not clear that whether there are any other factors determining the clinical presentations. The purpose of this study was to analyze the risk factors for the aggressive presentations of DAVFs. Methods A total of 190 cases with DAVF who were treated in Clinical Center of Neuroscience of Changhai Hospital of Second Military Medical University from January to December of 2012 were reviewed retrospectively. Patients were divided into two groups, aDAVF group and nDAVF （non-aggressive DAVF ） group. The difference between two groups was analyzed and Logistic regression analysis was performed concerning the clinical features and angioarchitecture. Results The Logistic regression analysis showed that DAVFs involving the large venous sinus （ P 〈 0. 001 ） , Borden II （ P 〈 0. 001 ） and BordenⅢ（ P = 0. 002 ） drainage pattern were the independent risk factors of aggressive manifestation. Conclusion DAVFs involving the large venous sinus, Borden II and Borden III drainage pattern are the independent risk factors of aggressive manifestation.