脑动脉瘤破裂风险因素的临床研究

Clinical Study on Rupture Risk Factors of Cerebral Aneurysm

目的探讨影响脑动脉瘤破裂的相关因素,评估和预测动脉瘤破裂风险,降低颅内动脉瘤患者的致残率及病死率。方法经CT及CTA检查确诊脑动脉瘤患者78例,其中分为A组(动脉瘤破裂组)45例,B组(动脉瘤未破裂组)33例,统计分析比较两组患者的性别、年龄、相关病史等情况以及CTA测量的相关指标。结果两组患者性别比较,差异具有统计学意义(χ2=4.562,P=0.033),其中女性更容易破裂;年龄分布,两组差异无统计学意义(t=1.748,P=0.084);高血压病史比较,差异有统计学意义(χ2=8.814,P=0.003);高血脂病史比较,表明两组差异无统计学意义(χ2=1.363,P=0.243)。两组患者在动脉瘤瘤颈宽度、瘤体高度上差异无统计学意义(P>0.05)。动脉瘤瘤体高度和瘤颈宽度比值(AR)两组差异有统计学意义(t=9.978,P=0.003);两组动脉瘤瘤体高度和载瘤动脉长轴的角度值(AN)比较,差异有统计学意义(t=3.182,P=0.002)。结论女性动脉瘤患者,动脉瘤更容易破裂导致蛛网膜下腔出血,高血压很可能是破裂的重要诱因;CTA影像提示瘤体高度和瘤颈宽度比值及动脉瘤生长角度AN很可能是临床预测动脉瘤破裂的重要指标。

Objective To explore the related factors of cerebral aneurysm ruptured risk, evaluate and predict risk of aneurysm rup-tured, reduce morbidity and mortality of intracranial aneurysm patients.Methods The patients with cerebral aneurysm diagnosised by CT and CTA examination were 78 cases, which were divided into A group （45 cases of ruptured aneurysm） and B group （33 cases unruptured aneurysm） .Gender, age,related to histories and related indicators of CTA measurement of two groups patients were statistical analysised and comparised.Results The gender comparison of the two groups patients was statistical significance（χ^2 =4.562, P=0.033）,and fe-male patients were more likely to rupture.Age distribution was no significant difference of the two groups （t=1.749, P=0.084）.Hy-pertension history comparison was statistically significant （χ2 =8.814, P=0.003）,and hyperlipidemia history comparison was no signifi-cant difference between the two groups （χ^2 =1.363, P=0.2431） .The aneurysmal neck width and aneurysmal body height were no statis-tical difference （P〉0.05）.The ratio （AR） of aneurysm body height and neck width of two groups was statistical difference （t=9.978, P=0.003）.Comparison of AN value of two groups was significant （t=3.182, P=0.002）.Conclusion Aneurysm of female patients are prone to rupture,even subarachnoid hemorrhage, hypertension is likely to be an important cause.CTA imaging suggested the ratio of aneurysmal body height and width ,aneurysm growth angle AN were likely to be an important indicator of the clinical prediction of aneu-rysm rupture.