摘要
目的探讨脑动脉粥样硬化性狭窄患者合并颅内动脉瘤(IA)的血流动力学特征及其危险因素。方法收集2019年9月至2023年1月在安徽医科大学附属宿州医院接受治疗的160例脑动脉粥样硬化性狭窄患者的临床资料。所有患者均进行了CT血管成像(CTA)以及数字减影血管造影(DSA)检查,依据影像学检查结果分为合并IA组(25例)和单纯狭窄组(135例)。比较2组基线资料信息、血流动力学指标。采用多因素Logistic回归分析探讨脑动脉粥样硬化性狭窄患者合并IA的危险因素。通过受试者操作特征(ROC)曲线分析壁面切应力(WSS)及振荡切应指数(OSI)预测脑动脉粥样硬化性狭窄患者合并IA的价值。结果合并IA组WSS、OSI均明显高于单纯狭窄组(P<0.05)。合并IA组中有吸烟史、糖尿病、高血压的百分比均高于单纯狭窄组(P<0.05)。多因素Logistic回归分析显示,吸烟史、糖尿病、高血压、WSS>0.450 Pa、OSI>0.057是脑动脉粥样硬化性狭窄患者合并IA的危险因素(P<0.05)。ROC曲线分析显示,WSS、OSI可用于预测脑动脉粥样硬化性狭窄患者合并IA,曲线下面积分别为0.857、0.784,敏感度分别为0.681、0.859,特异度分别为0.751、0.771(P<0.05)。结论脑动脉粥样硬化性狭窄患者合并IA的危险因素包括吸烟史、糖尿病、高血压、WSS>0.450 Pa、OSI>0.057。WSS、OSI可用于预测脑动脉粥样硬化性狭窄患者合并IA。
Objective To investigate the hemodynamic characteristics of patients with cerebral atherosclerotic stenosis and intracranial aneurysm(IA)and related risk factors.Methods Clinical data were collected from 160 patients with cerebral atherosclerotic stenosis who were treated in Suzhou Hospital of Anhui Medical University from September 2019 to January 2023.Computed tomography angiography(CTA)and digital subtraction angiography(DSA)were performed for all patients.According to the imaging findings,the patients were divided into stenosis+IA group with 25 patients and stenosis group with 135 patients.Baseline data and hemodynamic parameters were compared between the two groups.A multivariate logistic regression analysis was used to investigate the risk factors for IA in patients with cerebral atherosclerotic stenosis,and a receiver operating characteristic(ROC)curve analysis was used to assess the value of wall shear stress(WSS)and oscillatory shear index(OSI)in predicting IA in these patients.Results The stenosis+IA group had significantly higher WSS and OSI than the stenosis group(P<0.05).Compared with the stenosis group,the stenosis+IA group had a significantly higher proportion of patients with smoking history,diabetes or hypertension(P<0.05).The multivariate logistic regression analysis showed that smoking history,diabetes,hypertension,WSS>0.450 Pa,and OSI>0.057 were risk factors for IA in patients with cerebral atherosclerotic stenosis(P<0.05).The ROC analysis showed that WSS and OSI could be used to predict IA in patients with cerebral atherosclerotic stenosis,with an area under the ROC curve of 0.857 and 0.784,respectively,a sensitivity of 0.681 and 0.859,respectively,and a specificity of 0.751 and 0.771,respectively(P<0.05).Conclusions Smoking history,diabetes,hypertension,WSS>0.450 Pa,and OSI>0.057 are risk factors for IA in patients with cerebral atherosclerotic stenosis,and WSS and OSI can be used to predict IA in these patients.
作者
年夫顺
钟平
朱刚
张蕾
马争飞
薛庆华
NIAN Fushun;ZHONG Ping;ZHU Gang;ZHANG Lei;MA Zhengfei;XUE Qinghua(Department of Neurology,Suzhou Hospital of Anhui Medical University,Suzhou,Anhui 234000,China)
出处
《国际神经病学神经外科学杂志》
2024年第1期35-39,共5页
Journal of International Neurology and Neurosurgery
