破裂的颅内动脉瘤大小及其相关因素分析

目的：探讨颅内破裂动脉瘤的临床及影像学特点与瘤大小之间的关系。方法：回顾性分析2005年1月～2006年12月在我科行全脑血管造影并经手术证实有动脉瘤的患者264例，分别研究〈5nm和≥5mm的破裂动脉瘤的临床及影像学特点，分析动脉瘤的位置、患者的血压、年龄、性别、血糖以及瘤体长径／宽径比值与瘤体大小之间的关系。结果：264例患者共发生动脉瘤302个，其中破裂动脉瘤273个，未破裂动脉瘤29个，9例患者同时患有2个破裂动脉瘤，〈5mm的动脉瘤87个，≥5mm的动脉瘤186个。动脉瘤的部位、患者的血压、年龄、性别以及血糖与破裂动脉瘤的大小无明显关系（P〉0．05）。瘤体长径／宽径比值与动脉瘤大小之间有明显的统计学差异（P=0．002）。位于前交通动脉、后交通动脉起始处以及50～60岁年龄段的患者，其破裂的颅内小动脉瘤分别为33个（37．93％）、27个（31．03％）和38个（43．68％），要多于其它部位及其它年龄段。结论：动脉瘤的部位、患者的血压、年龄、性别以及血糖对动脉瘤的大小无明显影响；最大径〈5mm的颅内动脉瘤也有一定的破裂风险，其数目也达到一定的比例；瘤体长径与宽径比值或许可用来预测颅内不同大小动脉瘤的破裂风险。

Analysis on the size and relative factors of intracranial ruptured aneurysms

Objective：To explore the relationstfip between the size and the characteristics of the angiography and clinic of the ruptured cerebral aneurysms. Methods： We retrospectively analyzed 264 patients with cerebral aneurysms, Milch were certificated by conventional angiography and operation at our institute between Jan 2005 and Dee 2006, to study the clinical and angiographic features of the ruptured cerebral aneurysms between file size 〈 5 mm and ≥5 ram, and to analyze the relationship between the size and rite location of the intracranial raptured aneurysms, the patients blood pressure, age, sex, blood glucose and the aspect ratio of aneurysms. Results：There were 302 cerebral anemysm among 264 patients, 273 were ruptured, 29 were tmruptured, 9 patients bed double ruptured aneurysms,87 were smaller titan 5mm, 186 were larger than 5mm. There are no obvious relationship between the size and location of the ruptured intracranial aneurysms, and the patients blood pressure, age, sex and blood glucose （ P 〉 0.05）. Signifieandy statistical difference was seen between the aspect ratio and the size of intraeranial raptured aneurysms （ P = 0.002）. The numbers of the ruptured small cerebral aneurysms of the patients at the age ranged front 50 ～ 60 years 38 （43.68%）, and located in AeomA 33 （37.93%） and the origination of PcomA 27 （31.03%） are more than other places and ages. Conchtsion：The location of the ruptured intracranial aneurysms, and the patients blood pressure, age, sex and blood glucose had no obviously influenee on size of intraeranial aneurysms ; the numbers of the aneurysrns less titan 5 mm in maximum diameter reached to a certain percentage, and had also the dangerous of rupture; the aspect ratio may be used for predicting aneurysm rupture in different size.