基底节区动静脉畸形脑出血危险因素研究

RISK FACTORS OF CEREBRAL HEMORRHAGE LED BY ARTERIOVENOUS MALFORMATIONS IN BASAL GANGLIA

目的分析基底节区动静脉畸形脑出血危险因素。方法选择本院2017年1月—2019年12月60例基底节区动静脉畸形脑出血患者作为观察组,另选择同期的60例基底节区动静脉畸形无脑出血患者作为对照组。分析观察组的脑出血类型及出血量,比较二组的性别、年龄、高血压、癫痫为首发症状、动静脉畸形部位、动静脉畸形大小、动静脉畸形合并动脉瘤、动静脉畸形供血动脉、动静脉畸形深静脉引流、动静脉畸形Spetzler分级情况。结果观察组患者脑出血类型及出血量分别为:壳核出血9例,出血量8~22 ml,平均(12.75±1.86)ml;丘脑局灶性出血5例,出血量7~18 ml,平均(8.26±0.83)ml;脑出血破入脑室34例,出血量17~52 ml,平均(24.67±4.51)ml;尾状核头出血12例,出血量9~18 ml,平均(10.32±1.16)ml。二组的性别、癫痫为首发症状率、动静脉畸形合并动脉瘤率比较,差异均无统计学意义(均P>0.05);观察组的年龄显著低于对照组,高血压患病率、丘脑动静脉畸形率、动静脉畸形>3cm发生率、动静脉畸形供血动脉为豆纹动脉率、动静脉畸形深静脉引流率、动静脉畸形Spetzler分级显著高于对照组,差异均有统计学意义(均P<0.05)。经多因素Logistic回归分析,年龄、高血压、动静脉畸形部位、动静脉畸形大小、动静脉畸形供血动脉、动静脉畸形深静脉引流、动静脉畸形Spetzler分级均是基底节区动静脉畸形脑出血的独立危险因素。结论年龄、高血压、动静脉畸形发生于功能区、动静脉畸形较大等均是基底节区动静脉畸形脑出血危险因素。

Objective To analyze the risk factors of cerebral hemorrhage led by arteriovenous malformations in basal ganglia.Methods From January 2017 to December 2019,sixty patients with arteriovenous malformation and cerebral hemorrhage in the basal ganglia region treated in Tangshan Workers Hospital were selected as the observation group,and sixty patients with no cerebral hemorrhage of arteriovenous malformations in the basal ganglia region during the same period were selected as the control group.The type and amount of cerebral hemorrhage in the observation group were analyzed.Gender,age,hypertension,epilepsy as the first symptom,arteriovenous malformation site,arteriovenous malformation size,arteriovenous malformation combined with aneurysm,arteriovenous malformed blood supply artery,arteriovenous malformation deep vein drainage,Spetzler classification of arteriovenous malformation were compared between the two groups.Results The types and volume of cerebral hemorrhage in the observation group were:9 cases of nucleus hemorrhage,8-22 ml,with an average of(12.75±1.86)ml;5 cases of focal hemorrhage of the thalamus,7-18 ml,with an average of(8.26±0.83)ml;34 cases of cerebral hemorrhage broke into the ventricle,the bleeding volume was 17-52 ml,,with an average of(24.67±4.51)ml;2 cases of caudate nucleus bleeding,9-18 ml,with an average of(10.32±1.16)ml.There was no significant difference in gender,epilepsy as the first symptom rate,and arteriovenous malformations combined with aneurysm rates in the two groups(P>0.05);the age of the observation group was significantly lower than that of the control group,and the hypertension rate and thalamic arteriovenous malformations were significantly lower.The rate of arteriovenous malformation>3 cm,the rate of lenticular artery,arteriovenous malformation deep vein drainage rate,arteriovenousmalformation Spetzler classification were significantly higher than those in the control group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age,hypertension,arteriovenous malformation site,arteriovenous malformation size,arteriovenous malformation blood supply artery,arteriovenous malformation deep vein drainage,arteriovenous malformation Spetzler classification were all arteriovenous malformations cerebral hemorrhage Independent risk factors.Conclusion Age,hypertension,arteriovenous malformations in the functional area,and large arteriovenous malformations are all risk factors for arteriovenous malformation cerebral hemorrhage in the basal ganglia.