医学信息2023，Vol.36Issue(24)：51-56,6.DOI:10.3969/j.issn.1006-1959.2023.24.009
颅内微小动脉瘤破裂的危险因素分析
Analysis of Risk Factors for Rupture of Very Small Intracranial Aneurysms
摘要
Abstract
Objective To explore the related risk factors of rupture of very small intracranial aneurysms(VSIA),and to provide guidance for the clinical management of unruptured intracranial microaneurysms.Methods A total of 99 patients of single very small intracranial aneurysms at Calmette Hospital Affiliated to Kunming Medical University from January 2016 to November 2021 were continuously included in the study.They were divided into ruptured group(n=48)and non-ruptured group(n=51)according to whether or not they ruptured.The clinical features,tumor location,shape and morphological parameters of the patients were retrospectively analyzed.Independent sample t test orx2test was used to analyze the significance of these factors.Multivariate logistic regression analysis was further performed on the statistically significant factors in the univariate analysis.The receiver operating characteristic curve was used to analyze the optimal threshold of each parameter to predict the rupture of microaneurysms.Results There were significant differences in aneurysm location,morphology,inflow angle,aneurysm angle,aspect ratio,volume to neck ratio,diameter-width ratio,size ratio,hypertension history and smoking history between the ruptured group and the non-ruptured group(P＜0.05).Multivariate Logistic regression analysis showed that smoking history,inflow angle,diameter-width ratio,volume to neck ratio and shape were independent risk factors for rupture of microaneurysms(P＜0.05).The ROC curve showed that the maximum area under the curve of the inflow angle was 0.864,which was the most accurate to evaluate whether the VSIA was ruptured.Conclusion Very small intracranial aneurysm with large inflow angles,diameter-width ratio,volume to neck ratio,irregularities in the aneurysm,and location in the anterior communicating artery are considered to be at high risk of rupture,and aggressive surgical intervention is recommended if conditions warrant.For patients with a history of hypertension and smoking,it is recommended to control blood pressure well,quit smoking,undergo regular digital subtraction angiography review,and timely surgical intervention if aneurysm morphology changes.关键词
颅内动脉瘤/微小动脉瘤/破裂Key words
Intracranial aneurysm/Very small intracranial aneurysms/Rupture分类
医药卫生引用本文复制引用
谢仁华,李泽奇,苏平,刘博虎,岑键昌,李俊彦..颅内微小动脉瘤破裂的危险因素分析[J].医学信息,2023,36(24):51-56,6.基金项目
云南省卫生科技计划项目(编号:2017NS086) （编号:2017NS086）
