目的 分析未破裂颅内动脉瘤在颅内动脉狭窄患者的发生率、临床特点,并探讨发生未破裂颅内动脉瘤的危险因素。 方法 收集自2012年1月至2015年12月在北京大学第三医院住院,数字减影血管成像(digital subtraction angiography,DSA)检查证实颅内动脉存在≥50%狭窄,并同时存在未破裂颅内动脉瘤患者的资料,并对患者临床、DSA影像资料进行回顾分析。结果 在273例≥50%颅内动脉狭窄的患者中,有17例(6.23%)存在未破裂颅内动脉瘤,患者年龄45-78岁,其中8例女性,9例男性。男性颅内动脉狭窄患者动脉瘤发病率为4.17%(9/216),女性颅内动脉狭窄患者动脉瘤发病率为14.4%(8/57),男、女性动脉瘤发病率差异有统计学意义( P〈0.05)。16例(94.12%)动脉瘤位于颈内动脉系统,仅1例(5.88%)动脉瘤位于基底动脉尖;11例(64.71%)动脉瘤位于狭窄血管的远端,2例(11.76%)位于狭窄血管的近端,另有4例(23.53%)动脉瘤与狭窄不在同一血管;Logistic多因素分析显示,性别是颅内动脉狭窄患者发生未破裂颅内动脉瘤的独立危险因素。结论 颅内动脉狭窄患者发生动脉瘤的可能性远高于普通人群,女性较男性颅内动脉狭窄患者更易发生未破裂颅内动脉瘤。
Objective To analyze the incidence of intracranial unruptured aneurysms in patients with intracranial artery stenosis, clinical features, and investigate the risk factors for unruptured intracranial aneurysms. Methods Medical records from all patients performed with digital subtraction angiography (DSA) who had been treated at Peking University Third Hospital, China, from January 2012 to December 2015 were retrospectively reviewed to identify cases coexistence with cerebral artery stenosis and unruptured intracranial aneurysm. Results Of 273 patients with cerebral artery stenosis (≥50%), intracranial unruptured aneurysms was observed in 17 cases (6.23%) from age of 45 to 78, among them 8 (47.06%) were fcmale and 9 (52.94%) were male. The incidence of unruptured intracranial aneurysm in male patients was 4.17% (9/216), and that of fcmale was 14.4% (8/57). There was statistically significant difference between the male and fcmale incidence of intracranial aneurysm ( P〈0.05). Of these 17 patients, 16 (94.12%) aneurysms were located in the internal carotid artery (ICA) system, 1 (5.88%) aneurysm was located at the tip of the basilar artery. In 11 cases (64.71%), aneurysms were located at the distal of the stenotic vessels, 2 (11.76%) were located at the proximal of the stenotic vessels, and 4 cases (23.53%) of which the aneurysm and stenosis were not in the same artery. Logistic multivariate analysis showed that gender was an independent risk factor for aneurysms in patients with cerebral arterial stenosis. Conclusion In the intracranial artery stenosis atients, the possibility of the occurrence of the aneurysm is much higher than the general population, and women were more prominent than man. Sex is an independent risk factor for aneurysms in patients with cerebral arterial stenosis.