Li Guobin, Han Kun, Yang Haiying, Huang Hui, Yang Hong, Zhu Dezhang
Department of Neurosurgery, The Affiliated Hospital of Qingdao University Qingdao 266003, Shandong Province, P.R. China.
Int J Clin Exp Med. 2015 Jul 15;8(7):11014-9. eCollection 2015.
This study is to investigate risk factors of intracranial hemorrhage and their effects on prognosis in patients with brain intracranial arteriovenous malformation (AVM) after interventional therapy.
A total of 80 cases of brain AVM patients were admitted to our hospital and received interventional embolism treatment from December 2011 to July 2014. The patients all were confirmed by digital subtraction angiography. Risk factors of intracranial hemorrhage after interventional therapy were analyzed by multivariate analysis. The factors included age, sex, AVM diameter, vein drainage types, embolism area, etc. Meanwhile, the patients were followed up for 60 months after interventional embolism therapy, so as to assess the impact of related risk factors on prognosis.
By logistic regression analysis, it was found that age, AVM diameter, AVM combined with aneurysm, embolism area and venous drainage types were related risk factors those could lead to intracranial hemorrhage. Meanwhile, it was identified by receiver operating characteristic curve that embolism area, AVM diameter and AVM combined with aneurysm were risk factors had considerable influence on prognosis while the diagnosis significance of age and venous drainage types was poor (P > 0.05). The survival curves of embolism area and AVM diameter on prognosis had been identified by Kaplan-Meier analysis and it showed that embolism area < 50% and AVM diameter ≥ 3 cm had a better prognosis than embolism area ≥ 50% and AVM diameter < 3 cm (P < 0.05).
A series of risk factors were related to intracranial hemorrhage and some of them had considerable influence on prognosis, which, could help to reduce the risk of intracranial hemorrhage and improve long-term survival rate.
本研究旨在探讨脑动静脉畸形(AVM)患者介入治疗后颅内出血的危险因素及其对预后的影响。
选取2011年12月至2014年7月我院收治的80例脑AVM患者,均接受介入栓塞治疗,所有患者均经数字减影血管造影确诊。采用多因素分析介入治疗后颅内出血的危险因素,包括年龄、性别、AVM直径、静脉引流类型、栓塞面积等。同时,对患者进行介入栓塞治疗后60个月的随访,以评估相关危险因素对预后的影响。
经logistic回归分析,发现年龄、AVM直径、AVM合并动脉瘤、栓塞面积及静脉引流类型是导致颅内出血的相关危险因素。同时,经受试者工作特征曲线分析确定,栓塞面积、AVM直径及AVM合并动脉瘤是对预后有较大影响的危险因素,而年龄和静脉引流类型的诊断意义较差(P>0.05)。经Kaplan-Meier分析确定了栓塞面积和AVM直径对预后的生存曲线,结果显示栓塞面积<50%且AVM直径≥3 cm的患者预后优于栓塞面积≥50%且AVM直径<3 cm的患者(P<0.05)。
一系列危险因素与颅内出血相关,其中一些对预后有较大影响,这有助于降低颅内出血风险并提高长期生存率。