Clinical Study On Influential Factors Of Intracranial Aneurysm Rupture

Objective To analyze the related risk factors of intracranial aneurysm rupture and provide objective reference for clinical prevention and treatment of intracranial aneurysm rupture hemorrhage.Methods A retrospective study was conducted to collect 104 cases of intracranial aneurysm patients admitted to our hospital from May 2017 to December 2018.There were 48 males and 56 females.The average age was 58.69 11.79 years.Among the 104 patients,there were 74 ruptured aneurysms,15 symptomatic unruptured aneurysms and 15 asymptomatic aneurysms.Patients with ruptured aneurysm were set as ruptured group(n=74),and other patients were set as non-ruptured group(n=30).The clinical data of the patients were collected and recorded,and the data of gender,age,smoking,drinking,hypertension,diabetes,heart disease,thyroid disease,stroke,tumor,aspirin use history,uric acid abnormality,hyperlipidemia,and family history of intracranial aneurysm were recorded and analyzed.Perform CTA checks,measured Neck width(Wn),Height(H),Length(L),Parent vessel average dimeter(Dv),Width(W)and calculated Aspect ratio(AR),Size ratio(SR),Heigth-width ratio(HWR),Bottleneck factor(BN).And the aneurysm morphology and its relationship with adjacent vessels were observed.The values of the detection parameters obtained by CTA were analyzed by ROC curve.Univariate analysis and multivariate Logistic regression analysis of intracranial aneurysm rupture were performed.Results The ROC curve shows that the area under the curve of SR is the largest,and the AUC value is 0.919.The AUC values of W,BN,H,AR,HWR and L were 0.630,0.676,0.642,0.678,0.677 and 0.623,respectively.All had statistical significance(P<0.05 or P<0.01).Logistic regression analysis results of influencing factors for intracranial aneurysm rupture showed that female,history of hypertension,middle cerebral artery,posterior communicating artery,anterior communicating artery,Wn,AR,L,SR,W,BN and ascus were selected as independent risk factors for intracranial aneurysm rupture.Conclusion Female,history of hypertension is independent risk factor for rupture of intracranial aneurysm.CTA has certain advantages in evaluating the shape,size and location of intracranial aneurysms.There is a significant correlation between the location of aneurysm and rupture,among which aneurysms in middle cerebral artery,anterior communicating artery and posterior communicating artery are more likely to rupture.The larger the aneurysm,the more irregular the shape,and the more likely the rupture of intracranial aneurysm will occur in patients with aneurysm.Clinicians should further understand the characteristics and risk factors of aneurysm,weigh various factors and formulate reasonable treatment plan.