脑动静脉畸形和脑前动静脉畸形的相关因素:病例对照研究

Rian Vilar Lima, Tayenne Nélly De Lucena Viana, Andressa Sobral Uchoa, Thiago Menezes Piancó Leal, Maria Vanessa Pereira dos Santos, Luís Sebastião De Carvalho Neto, Helvécio Neves Feitosa Filho, Yuri Borges Morais
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摘要

导言。脑和脑前动静脉畸形(BAVM)是导致青少年出血性中风的一个重要原因,虽然通常是一种先天性疾病,但多年来很容易被忽视。研究目的寻找脑动静脉畸形的预测因素。方法。病例对照研究以巴西国家卫生系统信息部(DATASUS)提供的卫生信息系统(TABNET)数据库为基础。研究收集了 2010 年至 2020 年间出生的脐带血管瘤患儿(ICD Q280 和 Q282)的信息,并与同期出生的所有其他患儿进行了比较。结果。共发现 75 例脑积水病例,其中 21 例为脑前积水,54 例为脑积水。女性患者占 55%(41 例)。对照组有 40,588,143 名婴儿。早产新生儿患脑血管瘤的几率大约是正常新生儿的10倍(P<0.001;OR:9.990;CI:6.347-15.725)。剖腹产导致脐膨出的几率高出 63%(P<0.001;OR:0.372;CI:0.219-0.632)。种族也与脐带血管瘤有关,尤其是白人患脐带血管瘤的几率是白人的 2.2 倍(P=0.001;OR:2.242;CI:1.379-3.643)。双胎妊娠与脑动静脉畸形略有关联(P=0.063;OR:0.361;CI:0.132-0.989)。结论早产、剖宫产和白种人与脑动静脉畸形显著相关。这些发现值得考虑,以指导筛查策略和临床怀疑。建议对同一主题进行前瞻性队列研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Factors associated with brain and pre-brain arteriovenous malformation: a case control study
Introduction. Brain and pre-brain arteriovenous malformations (BAVMs) are an important cause of hemorrhagic stroke among youth, although are normally a congenital condition, can easily pass unnoticed for years. Objective. To find predictors of BAVMs. Method. Case control study based in the database of the Health Information System (TABNET), made available by the Informatics Department of the Brazilian National Health System (DATASUS). Information of children born with BAVMs (ICD Q280 and Q282) ranging from 2010 to 2020 was collected and compared with all the other childrens born at the same period of time. Results. A total of 75 cases of BAVMs were found, with 21 being pre-cerebral and 54 cerebral. Females represented 55% (41) of the patients. A cohort of 40,588,143 babies was used as control. Preterm newborns had an approximate 10 times higher chance of having BAVMs (p<0.001; OR:9.990; CI: 6.347-15.725). Cesarean birth was associated with 63% higher chance of BAVMs.(p<0.001; OR: 0.372; CI: 0.219-0.632). Ethnicity was also associated with BAVMs, notably with white ones having 2,2 times more chances of having BAVM (p=0.001; OR: 2.242; CI:1.379-3.643). Twin pregnancy was marginally associated with BAVMs (p=0.063; OR: 0.361; CI: 0.132-0.989). Conclusion. Prematurity, cesarean birth, and white ethnicity were significantly associated with BAVMs. These findings are worth considering to guide screening strategies and clinical suspicion. Prospective cohort studies in the same topic are recommended.
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