Wang Yanyan, Zhao Lin, Zhang Xiaolin, Zheng Jun, Geng Yanlu, Huang Boyuan, Chen Teng, Qiang Jing, Liu Bo, Zhang Lihong, Zhang Xiangjian
Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
The Key Laboratory of Neurology (Hebei Medical University), Ministry of Education, Shijiazhuang, China.
Quant Imaging Med Surg. 2024 Jan 3;14(1):376-385. doi: 10.21037/qims-23-820. Epub 2023 Nov 17.
Rupture of intracranial aneurysms (IAs) can cause subarachnoid hemorrhage (SAH), which leads to severe neurological dysfunction and even death. Exploring the risk factors for IA rupture and taking preventive measures accordingly can reduce or prevent the occurrence of SAH. Currently, there is still no consensus on the detrimental factors for IA rupture. Thus, our study aimed to investigate the risk factors of IA rupture in a population of northern China.
We systematically collected the demographic features, medical history, and imaging data of aneurysms from patients with ruptured and unruptured IAs (UIAs) who attended the Department of Neurosurgery at the Second Hospital of Hebei Medical University from 2014 to 2019. All cases had been diagnosed by digital subtraction angiography. We excluded patients with SAH resulting from injuries, as well as those with vascular dissection and incomplete data. Finally, 1,214 patients including 616 with ruptured IAs and 598 with UIAs were collected for further analysis. A case-control study was conducted, in which multivariable logistic regression was used to analyze the risk factors for IA rupture.
Our multivariable logistic regression showed that anterior cerebral artery [odds ratio (OR) =2.413; 95% confidence interval (CI): 1.235-4.718], anterior communicating artery (OR =3.952; 95% CI: 2.601-6.006), posterior communicating artery (OR =2.385; 95% CI: 1.790-3.177), and anterior circulation branches (OR =3.493; 95% CI: 1.422-8.581) were risk factors for IA rupture, whereas patients with a history of cerebral infarction (OR =0.395; 95% CI: 0.247-0.631) and those with IAs located in the internal carotid artery (OR =0.403; 95% CI: 0.292-0.557) were less likely to have IA rupture.
IAs at specific locations are prone to rupture. These IAs should be paid particular attention and preventive measures should be taken to reduce or prevent their rupture.
颅内动脉瘤（IA）破裂可导致蛛网膜下腔出血（SAH），进而引起严重的神经功能障碍甚至死亡。探索IA破裂的危险因素并采取相应的预防措施可减少或预防SAH的发生。目前，关于IA破裂的有害因素仍未达成共识。因此，我们的研究旨在调查中国北方人群中IA破裂的危险因素。
我们系统收集了2014年至2019年在河北医科大学第二医院神经外科就诊的破裂和未破裂IA（UIA）患者的人口统计学特征、病史和动脉瘤影像学数据。所有病例均经数字减影血管造影确诊。我们排除了因外伤导致SAH的患者，以及血管夹层和数据不完整的患者。最后，收集了1214例患者，其中616例为破裂IA患者，598例为UIA患者，用于进一步分析。进行了病例对照研究，采用多变量逻辑回归分析IA破裂的危险因素。
我们的多变量逻辑回归显示，大脑前动脉[比值比（OR）=2.413；95%置信区间（CI）：1.235 - 4.718]、前交通动脉（OR =3.952；95% CI：2.601 - 6.006）、后交通动脉（OR =2.385；95% CI：1.790 - 3.177）和前循环分支（OR =3.493；95% CI：1.422 - 8.581）是IA破裂的危险因素，而有脑梗死病史的患者（OR =0.395；95% CI：0.247 - 0.631）和IA位于颈内动脉的患者（OR =0.403；95% CI：0.292 - 0.557）发生IA破裂的可能性较小。
特定部位的IA容易破裂。应特别关注这些IA，并采取预防措施以减少或防止其破裂。
