Onyx胶与氰基丙烯酸正丁酯栓塞治疗脑动静脉畸形的比较

Comparison of Onxy and N-butyl-2-cyanoacrylate for the embolization of cerebral arteriovenous malformations

目的比较Onyx与氰基丙烯酸正丁酯胶（n-butyl-2-cyanoacrylate, NBCA）栓塞治疗脑动静脉畸形（arteriovenous malformations, AVM）的有效性和安全性。方法回顾性分析53例脑AVM患者（NBCA组31例，Onyx组22例）的临床资料，比较1年随访期的安全性及有效性，并根据AVM大小（直径〈3 cm、3～6 cm和〉6 cm）以及Spetzler-Martin分级进行亚组分析。结果Onyx组和NBCA组基线资料及AVM形态无显著性差异。Onyx组栓塞率显著高于NBCA组（P〈0.05），但术后1年随访期的术后出血（1/31对1/22；P＝1.000）和神经功能缺损（1/22对3/31；P＝0.633）发生率均无显著性差异。亚组分析显示，Onyx组对小型及中型脑AVM的栓塞率均显著高于NBCA组（P均〈0.05），而且对各Spetzler-Martin分级脑AVM的栓塞率均显著高于NBCA组（P均〈0.05）。 结论Onyx相较于NBCA胶的栓塞效果更优，且两者安全性相近。

ObjectiveTo compare the effectiveness and safety of Onyx and n-butyl-2-cyanoacrylate （NBCA） for the embolization of cerebral arteriovenous malformations （AVMs）.MethodsThe clinical data of 53 patients with cerebral AVMs （31 in the NBCA group and 22 in the Onyx group） were analyzed retrospectively. The safety and effectiveness of the 1-year follow-up were compared. The size of AVMs （diameters 〈3 cm, 3-6 cm, and 〉6 cm） and the Spetzler-Martin grade were used to conduct subgroup analysis.ResultsThere were no significant differences in the baseline data and AVM morphologies. The embolization rate in the Onyx group was significantly higher than that in the NBCA group （P〈0.05）, but there were no significant differences in the incidences of postoperative hemorrhage （1/22 vs. 1/31; P=1.000） and neurological deficit （1/22 vs. 3/31; P=0.633） in the 1-year follow-up after procedure. The subgroup analysis showed that the embolization rates of the small and medium-sized cerebral AVMs in the Onyx group were significantly higher than those in the NBCA group （all P〈0.05）, and the embolization rates of cerebral AVMs with different Spetzler-Martin grades in were significantly higher than those in the NBCA group （all P〈0.05）.ConclusionOnyx is equivalent to NBCA in safety but better in efficacy.