垂体腺瘤出血性卒中的危险因素分析

Analysis of risk factors related to hemorrhagic pituitary apoplexy

目的 探讨影响垂体腺瘤出血性卒中发生的危险因素。方法 回顾性分析青岛大学附属医院神经外科2010年1月—2021年1月收治的875例无功能垂体腺瘤患者的临床资料,并按照有无垂体腺瘤出血性卒中发生分为卒中组(88例)与非卒中组(787例),采用单因素分析及多因素Logistic回归分析筛选影响垂体腺瘤出血性卒中发生的危险因素。结果 卒中组患者中,抗栓药物治疗史、肿瘤复发或残留、有介入手术或介入造影史的比例均明显高于非卒中组,微腺瘤的比例明显低于非卒中组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析提示,大腺瘤(OR=0.189,95%CI:0.069~0.522,P=0.001)、抗栓药物治疗史(OR=4.168,95%CI:1.611~10.785,P=0.003)、溴隐亭治疗(OR=2.912,95%CI:1.156~7.34,P=0.023)、肿瘤复发或残留(OR=2.787,95%CI:1.179~6.59,P=0.020)是垂体腺瘤出血性卒中的独立危险因素。结论 存在大腺瘤、抗栓药物治疗史、溴隐亭治疗、肿瘤复发或残留等情况的垂体腺瘤患者较易发生垂体腺瘤出血性卒中。

Objective To investigate the risk factors of hemorrhagic pituitary adenoma apoplexy.Methods The clinical date of 875 patients with non-functioning pituitary adenoma from January 2010 to January 2021 in the Department of Neurosurgery,Affiliated Hospital of Qingdao University were analyzed retrospectively.According to the occurrence of pituitary adenoma hemorrhagic stroke,the patients were divided into stroke group(88 cases)and non-stroke group(787 cases).The risk factors affecting the occurrence of pituitary adenoma hemorrhagic stroke were screened by univariate analysis and multivariate logistic regression analysis.Results The proportion of bromocriptine therapy,the history of taking antithrombotic drugs,recurrent or residual tumor,and the history of intervention operation in the patient with pituitary apoplexy were higher than those without pituitary apoplexy.The proportion of microadenoma in pituitary adenoma apoplexy group was lower than non-apoplexy group.The difference between the two groups has statistical significance(P<0.05).Multivariate logistic regression analysis indicated that macroadenoma(OR=0.189,95%CI:0.069-0.522,P=0.001),the history of taking antithrombotic drugs(OR=4.168,95%CI:1.611-10.785,P=0.003),bromocriptine therapy(OR=2.912,95%CI:1.156-7.34,P=0.023)and recurrent or residual tumor(OR=2.787,95%CI:1.179-6.59,P=0.020)were independent risk factors of pituitary apoplexy.Conclusion The risk factors of hemorrhagic pituitary apoplexy are macroadenoma,the history of taking antithrombotic drugs,bromocriptine therapy and recurrent or residual tumor.