颅内囊性动脉瘤破裂形态学的危险因素分析

目的研究颅内囊性动脉瘤破裂的形态学危险因素。方法回顾性分析551例（共611个）颅内囊性动脉瘤的病例资料,以动脉瘤破裂作为最后评定指标,分为破裂组（341个动脉瘤）和未破裂组（270个动脉瘤）,使用SPSS17.0统计软件包分析数据。结果两组之间动脉瘤长、瘤颈宽、载瘤动脉平均直径、载瘤动脉近端与动脉瘤长轴夹角（IA）、瘤体长与瘤颈宽之比（AR）、瘤体最大径与载瘤动脉平均直径之比（SR）、动脉瘤面积与瘤颈处动脉面积之比（S1/S2）、存在子瘤有显著差异（P〈0.05）。多因素Logistic回归分析显示：瘤颈宽〈1.7 mm（OR=2.318,95%CI=1.381-3.893,P=0.001）、存在子瘤（OR=12.512,95%CI=7.827-20.002,P〈0.001）、S1/S2〉2.1（OR=2.460,95%CI=1.408-4.300,P=0.002）为颅内囊性动脉瘤破裂的独立危险因素。结论动脉瘤长、瘤颈宽、载瘤动脉平均直径、IA、AR、SR、S1/S2、存在子瘤是动脉瘤破裂的形态学危险因素。

Analysis of risk factor for intracranial saccular aneurysm rupture

Objective To investigate the morphological risk factors for rupture of intracranial saccular aneurysm. Methods The clinical data of 551 patients（611 aneurysms） with intracranial saccular aneurysms were analyzed retrospectively. According to aneurysm rupture as the final evaluation index, the patients were divided into rupture group（341 aneurysms） and unruptured group（270 aneurysms）. The SPSS17.0 statistical package was used. Results There were significant differences between the two groups in the aneurysm length,aneurysm neck width, average diameter of parent artery, inflow angle（IA）, ratio of body length to neck wide of the aneurysm（AR）, ratio of body length to average diameter of the parent artery（SR）, aneurysm area/aneurysm neck＇s artery area（S1/S2） and existence of daughter aneurysm（P〈0.05）. Multiple variables logistic regression analysis shows that neck width 1.7 mm（OR = 2.318, 95% CI =1.381-3.893, P = 0.001）, existing daughter aneurysm（OR = 12.512, 95% CI = 7.827-20.002, P〈 0.001）, S1/S2〉2.1（OR = 2.460, 95% CI =1.408-4.300, P = 0.002） were independent risk factors for rupture of intracranial saccular aneurysm. Conclusion The aneurysm length,aneurysm neck width, average diameter of the parent artery, IA, AR, SR, S1/S2 and existence of daughter aneurysm all can be testified as morphological risk factors for rupture of saccular aneurysm.