作者单位:221000徐州医科大学附属医院神经外科通信作者:冯力,电子信箱:david1371@163.com前交通动脉瘤破裂的血管和动脉瘤形态学危险因素分析蒋中晁晓峰张桐汤宏杰冯力摘要目的探讨前交通动脉瘤(anteriorcommunicatingarteryaneurysm,ACoA)破裂的血管和动脉瘤形态学危险因素。方法回顾性收集2016年6月~2022年12月徐州医科大学附属医院收治的211例ACoA患者,按其是否破裂分为破裂组(n=149)和未破裂组(n=62),收集患者的一般资料,测量大脑前动脉分叉角度、动脉瘤形态学参数和优势侧大脑中动脉(middlecer-ebralartery,MCA)始段、大脑前动脉A1始段和颈内动脉(internalcarotidartery,ICA)末端的直径及A1/ICA夹角。采用多因素Logistic回归分析评价ACoA破裂的危险因素,采用Spearman秩相关分析评价大脑前动脉A1始段、MCA始段、ICA末端的直径和A1/ICA角与ACoA破裂的关系。结果年龄、高血压、高宽比(aspectratio,AR)、瘤体不规则、A1段变异、A2/前交通动脉(ante-riorcommunicatingartery,Acom)角、入射角是影响ACoA破裂的危险因素。A1/ICA角与ACoA破裂呈正相关,而MCA始段直径与ACoA破裂呈负相关。结论除了年龄、高血压、AR、瘤体不规则是ACoA破裂的危险因素外,A1段变异、A2/Acom角、入射角等血管形态学对ACoA破裂具有一定的预测作用。此外,当A1段发生变异,优势侧A1/ICA角越大,MCA始段直径越小,ACoA越容易破裂。关键词前交通动脉瘤破裂形态学危险因素中图分类号R651文献标识码ADOI10.11969/j.issn.1673-548X.2024.03.034RiskFactorAnalysisofVascularandAneurysmMorphologyforRupturedAnteriorCommunicatingArteryAneurysm.JIANGZhong,CHAOXiaofeng,ZHANGTong,etal.DepartmentofNeurosurgery,AffiliatedHospitalofXuzhouMedicalUniversity,Jiangsu221000,ChinaAbstractObjectiveToinvestigatetheriskfactorsofvascularandaneurysmmorphologicalforruptureofanteriorcommunicatingarteryaneurysm(ACoA).MethodsAtotalof211patientswithACoAadmittedtotheAffiliatedHospitalofXuzhouMedicalUniversityfromJune2016toDecember2022wereretrospectivelycollected,andtheyweredividedintorupturedgroup(n=149)andunrupturedgroup(n=62)accordingtowhethertheywererupturedornot.Thegeneraldataofthepatientswerecollected,thebifurcationangleoftheanteriorcerebralartery,themorphologicalparametersoftheaneurysm,thediametersofthebeginningsegmentofthedominantside...
