| [Objective]:To investigate the effect of clinical and morphological characteristics of intracranial microaneurysm on aneurysm rupture?[Methods]:A total of 202 patients with intracranial microaneurysm who were treated in the First Affiliated Hospital of Kunming Medical University from January 2016 to November 2018 were collected.All patients underwent whole brain angiography(DSA)examination inside and outside the hospital to confirm the diagnosis.Collect clinical characteristics of patients,including gender,age,history of hypertension,admission blood pressure,history of diabetes,admission blood glucose,smoking history;DSA collected the location and morphological characteristics of aneurysms of patients,including neck,length,width,AR,SR ratio,whether the morphology is regular,whether there is an ascus and calculate the aneurysm volume and the ratio of the volume to the neck area of the aneurysm.Data analysis was performed using SPSS 24.0 software.Comparisons between groups were performed using T-test or chi-square test.Risk factors were first analyzed by multivariate logistic regression analysis,and the optimal critical values were calculated by ROC curve analysis of some risk factors.[Results]:Compared with the intracranial microaneurysm rupture group and the non-rupture group,the microaneurysm located in the anterior communicating artery and middle cerebral artery had a higher rupture rate.The prevalence and rupture rate of microaneurysms in female patients were higher than those in men,but the results were not.Statistical significance.Systolic blood pressure(p=0.000),Diastolic blood pressure(p=0.043),blood glucose(p=0.000),aneurysm position(p=0.000),with ascites(p=0.000),irregular shape(p=0.004),The difference between AR(p=0.009SR(p=0.004)was statistically significant.Multiple logistic regression analysis showed systolic blood pressure(OR 1.037 95%CI 1.01-1.066 p=0.007)and blood glucose value(OR 1.520 95%CI 1.179-1.959 p=0.001),with ascites(OR 6.52695%CI 2.194-19.415 p=0.001),irregular shape(OR 4.573 95%CI 2.403-8.706 p=0.000),AR(OR 2.521 95%CI 1.263-5.032 p=0.009)and SR(OR 2.567 95%CI 1.324-4.979 p=0.005)were independent risk factors for rupture.The ROC curve showed that the best predictive value of blood glucose was 5.55mmol/l(area under the curve 0.674 95%CI 0.586-0.761),the best predicted value of systolic blood pressure is 130mmhg(area under the curve 0.707,95%CI 0.634-0.780),the best predicted value of AR is 1.13(area under the curve 0.621,95%CI 0.540-0.703),the best predicted SR The value is 1.25(area under the curve 0.614,95%CI 0.533-0.694).[Conclusion]:1.Systolic blood glucose is an independent risk factor for the rupture of intracranial small aneurysms.The optimal critical value of systolic blood pressure is 130mmhg.The optimal critical value of blood glucose is 5.55mmol/l.Aneurysms should attract active attention;2.Irregular morphocysts are independent risk factors for rupture of intracranial small aneurysms,and the risk of rupture of small aneurysms with this condition is increased by 4.57 times and 6.53 times;3.The ratio of long neck to AR size SR is an independent risk factor for rupture of intracranial small aneurysms,and the optimal cut-off values are 1.13 and 1.25,respectively.For small aneurysms with AR SR exceeding this critical value,the risk of rupture is greatly increased,and full attention should be paid in clinical... |
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