Stroke:解剖变异是前交通动脉复杂体动脉瘤破裂患者脑血管痉挛的危险因素吗?

2020-01-24 xing.T MedSci原创

由此可见,前交通动脉的解剖学变异可能是一种新的生物标记,可以识别出蛛网膜下腔出血后有发生血管造影血管痉挛风险的患者。需要外部验证队列来确认这些结果。

破裂的动脉瘤的三分之一位于前交通动脉复合体上,该动脉节段的解剖学变异患病率很高。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,在这项研究中,研究人员假设前交通动脉复合体的解剖变异会增加血管造影血管痉挛的风险。

该回顾性研究前瞻性地收集了2002年至2018年间神经重症监护单中心蛛网膜下腔出血队列患者的数据。采用单因素及多元Logistic回归分析来确定与血管造影血管痉挛相关的因素。

该研究共有1374例动脉瘤性蛛网膜下腔出血患者入院。29.8%(n=410)的患者与前交通动脉复杂性动脉瘤破裂有关;其中9.2%(n=38)的患者表现为前交通动脉变异。该亚组中55.6%的患者被诊断为血管造影血管痉挛(vs 28.1%,P=0.003)。在多变量分析中,外部脑室引流(2.2 [1.32–3.65],P=0.003)和前交通动脉变异(2.40 [1.2–4.9],P=0.04)独立且显著与血管造影血管痉挛相关,而年龄大于60岁(0.3 [0.2–0.7];P=0.002)是一个保护因素。前交通动脉瘤破裂后,前交通动脉变异与缺血性血管痉挛或不良的神经系统预后之间没有统计学关系。

由此可见,前交通动脉的解剖学变异可能是一种新的生物标记,可以识别出蛛网膜下腔出血后有发生血管造影血管痉挛风险的患者。需要外部验证队列来确认这些结果。

原始出处:

Alice Jacquens .et al.Is Anatomical Variations a Risk Factor for Cerebral Vasospasm in Anterior Communicating Complex Aneurysms Rupture.stroke.2020.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.026661

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    2020-11-27 yese
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    2020-01-26 apoenzyme
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    2020-01-26 yuandd
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    2020-01-25 飛歌

    学习了很有用不錯

    0

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    2020-01-24 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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