儿童脑动静脉畸形出血危险因素分析

目的   研究儿童脑动静脉畸形（cerebral arteriovenous malformation，CAVM）临床特点及形态特点，评估其破裂出血的相关因素。方法  回顾性分析2012年1月～2014年12月首都医科大学附属北京天坛医院收治年龄小于14岁CAVM患者73例，均经数字减影血管造影（digital subtraction angiography，DSA）检查明确诊断。采用单变量及多变量Logistic回归分析儿童入院时CAVM破裂出血与患者性别、年龄、CAVM侧别、DSA最大径、是否合并动脉瘤、病变是否位于深部、是否纯深静脉引流及静脉引流类型（浅静脉、深静脉及浅静脉合并深静脉）等因素的关系。结果  共73例儿童CAVM患者纳入研究，其中49例入院时合并出血，出血率为67.1%。CAVM直径小是儿童CAVM出血的独立危险因素［比值比（odds ratio，OR）0.96，95%可信区间（confidence interval，CI）0.93～099，P＜0.05］。结论  儿童CAVM破裂出血与动静脉畸形大小有关。

Rick Factors for Cerebral Arteriovenous Malformation Hemorrhage in Pediatric Patients

Objective To investigate the clinical and morphological features of cerebral arteriovenous malformation (CAVM) in children and to assess its risk factors of hemorrhage in pediatric patients.
Methods The clinical data of pediatric patients admitted to Beijing Tiantan Hospital for CAVMs between 2012 and 2014 were retrospectively analyzed. All patients were diagnosed using digital subtraction angiography. The effects of demographic characteristics and CAVM morphological characteristics on hemorrhage presentation were studied using univariate and multivariate Logistic regression analysis. The characteristics including the gender, age, deep location, malformation diameter, AVM side, venous drainage, associated aneurysms.
Results Seventy-three pediatric CAVM cases were identified, 49 (67.1%) cases presented with hemorrhage. The malformation diameter had significant difference on the malformation, (odds ratio [OR] 0.96, 95% confidence interval [CI] 0.93~0.99, P<0.05). The gender, age, AVM side, deep location, deep venous drainage, associated aneurysms, venous drainage did not have significant difference on the malformation.
Conclusion Hemorrhagic brain arteriovenous malformations relate with the malformation diameter, and the malformations with small AVM diameter should be treated early to reduce morbidity andmortality.