前交通动脉瘤与大脑前动脉A1段缺如相关性研究

目的：探讨前交通动脉瘤（ACoA）发病及伴蛛网膜下腔出血与大脑前动脉A1段缺如的相关性。方法：回顾性分析705例全脑血管造影及临床资料,其中47例ACoA患者为研究组,129例无脑血管病变患者为对照组,比较ACoA发病、动脉瘤大小及蛛网膜下腔出血与大脑前动脉A1段缺如相关性。结果：47例ACoA患者中,大脑前动脉A1段缺如发生率为44.7%,对照组129例患者中大脑前动脉A1段缺如发生率为9.3%,ACoA患者伴大脑前动脉A1段缺如发生率明显高于对照组,差异有显著性意义（χ^2=28.303,P〈0.001）。21例伴A1段缺如的ACoA动脉瘤平均直径（5.8±2.8）mm,26例无A1段缺如的ACoA动脉瘤平均直径（4.2±2.2）mm,二者差异有显著性意义（t=2.098,P〈0.05）。21例伴A1段缺如的ACoA,其蛛网膜下腔出血程度与大脑前动脉A1段缺如相关（Z=-2.199,P〈0.05）。结论：前交通动脉瘤发病、动脉瘤大小以及伴发蛛网膜下腔出血均与大脑前动脉A1段缺如相关,大脑前动脉A1段缺如患者的ACoA发生率明显增高。

Correlational research on anterior communicating aneurysms and the absence of A1 segment of anterior cerebral artery

Objective：To study the correlation of the incidence of the anterior communicating aneurysms（ACoA） with subarachnoid hemorrhage and the absence of the A1 segment of the anterior cerebral artery.Methods：The cerebral angiography and clinical data of 705 cases were retrospectively analyzed,including 47 cases with ACoA were collected as the study group,129 cases without cerebral vascular disease as the control group.The ACoA morbidity,aneurysm size and associated subarachnoid hemorrhage were correlated with the absence of the A1 segment of the anterior cerebral artery.Results：Among 47 ACoA patients,the incidence of the absence of the A1 segment of the anterior cerebral artery was 44.7%,as that in the control group was 9.3%,the difference was statistical significance（χ^2=28.303,P〈0.001）.Among 21 ACoA patients associated with the absence of the A1 segment of the anterior cerebral artery,the mean diameter of ACoA was（5.8±2.8）mm,for 26 ACoA cases without the absence of the A1 segment of the anterior cerebral artery,the mean diameter of ACoA was（4.2±2.2）mm,the difference was statistical significant（t=2.098,P〈0.05）.Among 21 ACoA patients associated with the absence of the A1 segment of the anterior cerebral artery,the subarachnoid hemorrhage was relevant to the absence of the A1 segment of the anterior cerebral artery（Z=-2.199,P〈0.05）.Conclusion：Our results demonstrated the ACoA morbidity was significantly increased in patients with the absence of the A1 segment of the anterior cerebral artery.It is related to the absence of the A1 segment of the anterior cerebral artery on the aneurysm size and associated subarachnoid hemorrhage.