The Risk Factors Of Intracranial Aneurysms Ruptured

Objective (s):By analyzing the morphological characteristics and individual factors, To investigate the risk factors of aneurysm rupture.Methods:The clinical data of aneurysm patients treated in our hospital between April 2013 and June 2015 were analysised retrospectively, including clinical data of patients、aneurysm morphology. We analyzed data the whole and stratified. Results:1) the factors of hypertension, high blood sugar, smoking is a statistical difference between the two groups. Blood pressure rupture group (137±24) mmHg and unruptured group (125±19) mmHg, single factor regression blood pressure caused rupture of aneurysm critical value is 130.5mmHg that contraction pressure is greater than the 130.5mmHg intracranial aneurysm rupture risk is 3.41 times less than 130.5mmHg aneurysm. Rupture of blood glucose (6.6+2.1) mmol/L、unrupture group (5.7+2.2 mmol/L), single factor regression analysis of blood sugar caused by aneurysm rupture of the critical value is the 5.25mmol/L that of blood glucose values greater than 5.25 mmol/L) aneurysm rupture risk is that blood sugar value 3.71 times less than 5.25mmol/L. Smoking between the two groups were statistically significant differences, further analysis shows that with the increase cigarette smoking, the risk of aneurysm rupture increased. Blood lipid:ruptured aneurysms LDL, HDL, TG,TC were:2.86+0.82mmol/L,1.17+0.36mmol/L,4.42+0.98mmol/L,1.48+ 1.10mmol/L. The unrupture group were:2.70+0.85mmol/L,1.27+0.72mmol/L, 4.31+0.95mmol/L,1.58+1.37mmol/L. Further analysis lipid data group showed: HDL> 0.9 mmol/L when the ratio of unrupture group was higher than rupture group, while LDL> 3.3 mmol/L, the ratio of rupture group was higher than that of the unrupture group, but there was no statistical difference between the two groups.2) Aneurysm location is a risk factor for aneurysm rupture. There was a difference in the location of aneurysm between rupture group and unrupture group. The rupture group rate of anterior communicating artery (40%) and middle cerebral artery (27.62) was higher, and the internal carotid artery (32.2%) and middle cerebral artery (27.12%) were higher in unrupture group.3) Aneurysm shape, aneurysm length, width, neck width between the two groups, is difference between the groups. The shape of aneurysm rupture were irregular (46.67%) more unruptured group of non spherical (45.76%) more. The aneurysm length, width, neck width rupture group were:(519+2.99) mm, (4.58+2.63) mm, (3.71+1.82 mm) unruptured group respectively:(7.19+5.3) mm, (6.44+4.04) mm, (5.01+2.85 mm). According to the aneurysm length shows:the tumor length less than 5mm is more prone to rupture (60.38%).The critical value of the single factor regression rupture to the width and neck width of the aneurysm is 4.115mm and 6.195mm. That is, the width of the aneurysm less 6.195mm rupture risk is greater than 3.82 times the width of the aneurysm more 6.195mm, aneurysm neck width less 4.115mm is greater than 4.76 times aneurysm neck width more 4.115mm to rupture. The AR value the rupture group and the unrupture group were 1.51+1.02 and 1.49+0.81, respectively. There was no significant difference between the two groups. According to the AR value,AR value at 1.0-2.0 is higher risk of rupture (53.33%).4) Aneurysm hemodynamic factors can affect aneurysm rupture. The flow angle and The mainbranching angle of the ruptured aneurysm group were:(137.24+24.35), (118.3+28.96), and the unrupture group were:(120.07+24.58), (134.33+26.03). The critical value of the flow angle and the mainbranching angle to more ruptured of the aneurysms were 139.105 degrees and 121.35 degrees according to the single factor regression. That is, The aneurysm inflow angle greater 139.105 degrees is 4.202 times to lesser 139.105 degrees of aneurysm rupture, aneurysm of the mainbranching angle lesser 121.35 degrees is 4.281 time to greater 121.35 degrees to the aneurysm rupture.Conclusion(s):1) hypertension, hyperglycemia, smoking is the risk factors of rupture of the aneurysm, although the blood lipid of high density and low density lipoprotein has the difference between the two groups, but no statistical significance.2) aneurysms located atanterior communicating artery,the middle cerebral artery is relatively easy to rupture.3) irregular aneurysm, aneurysm length, width, less 5mm, aneurysm width less 6.195mm, aneurysm neck width less 4.115mm is the relative risk factors of aneurysm rupture. AR in the 1.0-2.0 rupture risk is higher, but there is no statistical difference between the two.4) the inflow angle greater 139.105, and the mainbranching angle less 121.35, which is the risk factor of ruptureThe indexes blood pressure, blood glucose, smoking, aneurysms located, irregularly aneurysm, aneurysm length, width, neck width, inflow angle, The mainbranching angle is associated with aneurysm rupture。They can as a predictor of aneurysm rupture. Hypertension, hyperglycemia, smoking, larger aneurysm, aneurysm neck smaller, the large inflows, smaller the mainbranching angle, irregularly shaped is greater risk of aneurysm rupture. This provides some help for clinical work. For intervention and testify, patients choose a conservative treatment. We can according to blood pressureglucose critical value, smoking cessation and other related medical intervention to reduce the risk of aneurysm rupture, and thus raise the survival rate.