在老年人中,未破裂的内动脉瘤的危险因素不稳定
Simin Wang1, Jiewen Geng1, Yadong Wang1,2
1Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, No. 45 Changchun Street, Xicheng District, Beijing, 10053, China.
Acta neurochirurgica
|January 25, 2024
概括
患有未破裂的内动脉瘤的老年患者面临不良控制的高血压和高风险动脉瘤位置的风险. 这些因素是不稳定的关键指标,需要仔细监测或干预.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 血管医学 血管医学
背景情况:
- 缺乏标准化策略来评估老年患者未破裂的内动脉瘤 (UIA) 的稳定性.
- 老年患者具有独特的生理特征,影响动脉瘤的行为.
- 需要在这个人群中确定动脉瘤生长或破裂的特定风险因素.
研究的目的:
- 在60岁及以上的患者中评估动脉瘤不稳定 (生长或破裂) 的风险因素.
- 评估临床和形态参数与UIA不稳定性之间的关系.
- 在老年人群中建立动脉瘤进展的预测因子.
主要方法:
- 从2016年11月到2021年8月的UIA患者数据的回顾性分析.
- 专注于60岁及以上的患者,收集病史和动脉瘤形态.
- 使用计算机辅助半自动测量 (CASAM) 进行生长评估,计算生长/断裂率,并执行考克斯回归和卡普兰-梅尔分析.
主要成果:
- 研究包括了184名患有210例UIA的患者,并进行了506.6个动脉瘤年的随访.
- 观察到每年动脉瘤生长率为11.0% (23个动脉瘤) 和每年破裂率为0.21% (1个动脉瘤).
- 多变量分析确定控制不良的高血压 (P=0.011) 和高风险动脉瘤位置 (ACA,AcoA,PcoA,PC>4mm,ICAd,MCA,PC>7mm) (P=0.006) 作为不稳定的独立风险因素.
结论:
- 控制不良的高血压和特定的高风险动脉瘤位置是老年患者不稳定的重要预测因素.
- 调查结果强调,对于已确定的风险因素的老年UIA,需要进行警监测或及时干预.
- 强调个性化风险评估,以管理老年人内动脉瘤的风险.
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