Imaging Characteristics And Risk Factors Of Intracranial Aneurysms In Middle And High Altitude Areas

Objective:1.To analyze the preoccurrence site,size,shape,number and other morphological characteristics of intracranial aneurysms in middle and high altitude areas.2.To analyze the regional risk factors of intracranial aneurysm rupture in middle and high altitude areas.Methods:1.By retrospective analysis,144 patients who were definitely diagnosed as intracranial aneurysms in our hospital from January 2017 to December 2018 were included.Among them,71(49.30%)male patients and 73(50.70%)female patients which between 20 and 76 years old,with an average age of(49.87±10.21)years.Patients with intracranial aneurysms were divided into two groups:ruptured group and unruptured group.65 cases(45.10%)in the ruptured group and 79 cases(54.90%)in the unruptured group.2.General information of patients with unruptured or ruptured intracranial aneurysms(gender,age,nationality,altitude,smoking,drinking,hypertension,diabetes,etc.)was compared and analyzed.3.Comparative analysis of laboratory examination(blood lipid,blood glucose,blood homocysteine,blood uric acid,red blood cells,hemoglobin,etc.)of patients with ruptured and unruptured intracranial aneurysm4.According to the imaging data of CTA,DSA or MRA,count the position,size,shape,number and neck width of ruptured and unruptured intracranial aneurysms5.Statistical methods:SPSS22.0 was used to establish the database and analyze Counting data were expressed in frequency and percentage,Measurement data were represented by mean plus or minus standard deviation(±s),Independent sample t test was used to compare the differences between the two groups of measurement data,x~2test was used to compare the difference between counting data,Multivariate analysis was conducted using the Logistic regression all-variable model.The test level was?=0.05.Results:Among the 144 patients,a total of 175 intracranial aneurysms were detected,89in the unruptured group and 86 in the ruptured group.The mean size of intracranial aneurysms in the ruptured group was(5.67±3.73)mm,while the mean size of intracranial aneurysms in the unruptured group was(4.15±3.26)mm.The larger the aneurysm diameter,the higher the risk of rupture.The main sites of intracranial aneurysms in both groups were the internal carotid artery system,31.40%in the ruptured group and 43.80%in the unruptured group.The morphology of intracranial aneurysms in the two groups was mostly cystic.The morphology of intracranial aneurysms in the unruptured group was relatively regular,while that of the ruptured group was irregular.Both groups of intracranial aneurysms mainly occurred in the internal carotid artery system.Consistent with the general epidemiological data of intracranial aneurysms.Statistical analysis indicated that there were statistically significant differen ces(P<0.05)between the two groups in age(p=0.002),hypertension(p=0.023),smoking(p=0.042),alcohol consumption(p=0.037),statin(p<0.001),FBG(p<0.001),Hcy(p=0.021),number of aneurysms(p=0.046),WBC(p<0.001),Cr(p=0.044),BUA(p<0.001)and MCHC(p=0.016).Multivariate Logistic r egression analysis suggested that hypertension(p=0.026,OR=4.710),FBG(p=0.007,OR=1.940),age(p=0.001,OR=1.140),WBC(p=0.017,OR=1.118),BUA(p=0.021,OR=0.989)and statin(p=0.002,OR=0.039)were independent risk fac tors for aneurysm rupture.OR value showed that higher blood pressure,higher fasting blood glucose,older age and higher WBC were associated with an incr eased risk of aneurysm rupture,while BUA increased within a certain range an d statins were protective factors for intracranial aneurysm rupture.Conclusions:1.The common site(internal carotid artery).Size,shape,number and other morphological characteristics of intracranial aneurysms in middle and high altitude areas were consistent with the general epidemiological data of IAs.2.Age,hypertension,smoking,drinking,statins,FBG,Hcy,number of aneurysm,the WBC,Scr and BUA,MCHC may have an impact on intracranial aneurysms formation,growth,rupture,and high blood pressure,FBG,age,the WBC,BUA,statins may be the independent risk factors for intracranial aneurysms.Higher blood pressure,higher fasting blood glucose,older age and higher WBC may increase the risk of aneurysm rupture.Compared with the general data,the risk factors of intracranial aneurysm in middle and high altitude areas have no obvious regional risk factors.while BUA increases within a certain range and statins may be protective factors for intracranial aneurysm rupture.The effect of altitude on intracranial aneurysms still unknown.