【摘要】 目的 探讨腔内血栓形态学特征对腹主动脉瘤（AAA）破裂风险的影响，建立破裂风险预测模型。方法 选取78例行胸腹或腹主动脉CT血管造影的AAA患者，根据AAA是否破裂将患者分为完整组52例和破裂组26例。比较两组瘤体最大直径、血栓长度、血栓最大厚度和血栓体积。建立以最大直径为自变量的常规模型以及最大直径和血栓形态学特征为自变量的新模型，并以破裂风险分类准确率和受试者工作特征（ROC）曲线下面积（AUC）进行两种模型效能评估。结果 破裂组瘤体最大直径、血栓长度、厚度和体积均高于完整组，差异有统计学意义（P<0.05）。二元Logistic回归分析结果显示最大直径（OR=2.722,95%CI:1.024～7.237）和血栓最大厚度（OR=1.820,95%CI:1.105～2.997）是AAA破裂风险的独立影响因素。单变量常规模型和多变量新模型的破裂风险分类准确率分别为73.10%和80.30%,AUC分别为0.725和0.778。结论 最大直径和腔内血栓均是AAA破裂风险的独立影响因素，包括血栓形态学特征的多变量新模型有助于AAA破裂风险的个体化评估。更多还原

【Abstract】 Objective To explore the effect of intraluminal thrombosis on rupture risk of abdominal aortic aneurysm(AAA) and to generate the predictive model for rupture risk of AAA. Methods A total of 78 patients were enrolled into this retrospective study and split into two groups, named as group iAAA and group rAAA. Maximal diameter of AAA and length, maximal thickness and volume of intraluminal thrombosis were analyzed between group iAAA and group rAAA. The conventional model with only maximal diameter as independent variable and new model with characteristics of intraluminal thrombosis as independent variables were generated and evaluated using categorizing accuracy of rupture risk and area of under curve of ROC.Results The maximal diameter of AAA, length, maximal thickness and volume of intraluminal thrombosis in group rAAA were significantly greater than those in group iAAA, and statistically significant difference was shown between them(P<0.05). The maximal diameter(OR=2.722, 95% CI: 1.024～7.237) and maximal thrombosis thickness(OR=1.820, 95% CI: 1.105～2.997) were observed as independent predictors of AAA rupture risk using binary logistic-regression analysis. The categorizing accuracy of univariable conventional model and multi-variable new model were 73.10% and 80.30%, respectively, and AUCs were 0.725and 0.778, separately. Conclusions The maximal diameter of AAA and maximal thickness of thrombosis were predictors of rupture risk, and multi-variable new model including geometric characteristics of intraluminal thrombosis was useful for individual evaluation of rupture risk of AAA.更多还原