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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 and clinical features of unruptured intracranial aneurysms in patients with intracranial arterial stenosis and to explore the risk factors of unruptured intracranial aneurysms. Methods The patients were hospitalized at Peking University Third Hospital from January 2012 to December 2015. Digital subtraction angiography (DSA) examination confirmed the presence of ≥50% stenosis in the intracranial artery with unruptured intracranial Aneurysm patients, and clinical data of DSA, retrospective analysis. Results Among 273 patients with ≥50% intracranial arterial stenosis, 17 (6.23%) had unruptured intracranial aneurysms. The patients were 45-78 years old, including 8 women and 9 males. The incidence of aneurysm was 4.17% (9/216) in men with intracranial stenosis and 14.4% (8/57) in women with intracranial stenosis. The incidence of aneurysm was statistically different between male and female (P <0.05). 16 cases (94.12%) were located in the internal carotid artery system, only 1 case (5.88%) was located in the basilar artery; 11 cases (64.71%) were located in the distal part of the stenosed vessel, 2 cases (11.76% The other 4 vessels (23.53%) were not in the same vessel with stenosis. Logistic multivariate analysis showed that gender was an independent risk factor for unruptured intracranial aneurysm in patients with intracranial stenosis. Conclusion The incidence of aneurysm in patients with intracranial arterial stenosis is much higher than that in the general population. Women are more likely to have unruptured intracranial aneurysms than those with intracranial stenosis in men.