本研究中，搭建了开放性的颅内动脉瘤疾病在线数据库与研究创新平台，建立了全国性的颅内未破裂动脉瘤患者队列。采用大数据分析、生物与影像标志物检测分析、流行病学数据分析等多种研究方式，针对未破裂动脉瘤的发病因素、年破裂率、年增长率、疾病自然病史、破裂风险因素等科学问题进行了深入研究:1)建立EDC系统，搭建了全国性的颅内动脉瘤疾病在线数据库与研究创新平台;2)建立覆盖全国各地区的 UIA 患者队列，持续入组患者并随访;3)对我国颅内未破裂动脉瘤疾病流行病学特征进行描述与分析，阐释颅内未破裂动脉瘤的自然病程;4)开展了颅内未破裂动脉瘤发病病因研究等一系列子课题研究，探究了临床特征、影像特征、遗传表型、流体动力学特点等在颅内动脉瘤发病中的作用;5)明确了颅内未破裂动脉瘤的破裂率，并分析颅内未破裂动脉瘤患者病情进展及破裂危险因素;6)开展了颅内动脉瘤的大数据智能化检出与评价研究，提出了新的半自动化、全自动化识别动脉瘤并评估其参数的方法，以及人工智能判读动脉瘤稳定性的方法。7)对颅内未破裂动脉瘤研究成果进行了文献回顾与成果总结，制定了《中国颅内未破裂动脉瘤诊疗指南》。指南中对UIA的流行病学、影像检出、风险评估、介入治疗、开颅治疗及术后随访等方面进行了详细撰写，旨在以最新的循证医学证据指导我国UIA的规范性诊疗。本研究为颅内动脉瘤研究提供了全新的依托平台与丰富的研究资料。通过分析研究临床资料与影像数据，对颅内动脉瘤的发病因素、流行病学特征、自然病史、破裂风险因素、检测与评估手段等相关的科学问题进行了探索研究，为颅内未破裂动脉瘤的诊疗提供了详实的循证医学依据。英文(不超过2500个字符):In this study,an open online database and research innovation platform for intracranial aneurysm diseases was first established,and a nationwide cohort of patients with unruptured intracranial aneurysms was established on this basis.Big data analysis,biological and imaging marker detection analysis,epidemiological data analysis and other research methods were adopted,aiming at the problems of the onset of unruptured aneurysms,annual rupture rate,annual growth rate,natural history of the disease,rupture risk factors and other sciences.1)Established an EDC system and built a nationwide online database and research and innovation platform for intracranial aneurysm diseases;2)Enrolled patients in 20 participating centers across the country,established a UIA patient cohort covering all regions of the country,and continued to enroll and follow up patients;3)Organized the clinical data of the patient cohort,described and analyzed the epidemiological characteristics of unruptured intracranial aneurysms in my country,and explained the natural course of unruptured intracranial aneurysms;4)Relying on the established research platform and database,carried out a series of sub-projects such as the etiology of intracranial unruptured aneurysms,and explored the familial characteristics of clinical features,imaging features,genetic phenotypes,and fluid dynamic characteristics in the role of intracranial aneurysms and sporadic intracranial aneurysms;5)Clarified the rupture rate of unruptured intracranial aneurysms,and analyzed the disease progression and risk factors of rupture in patients with unruptured intracranial aneurysms;6)Carried out the big data intelligent detection and evaluation research of intracranial aneurysm.By using machine learning method to analyze the image data of aneurysm patients,a new semi-automated and fully automated method of identifying aneurysms and evaluating their parameters and the method of artificial intelligence to judge the stability of aneurysm were proposed.It provided a new method to improve the efficiency and accuracy of UIA clinical detection and evaluation.7)Reviewed the literature and summarized the research results of intracranial unruptured aneurysms,and formulated the"Guidelines for the Diagnosis and Treatment of Unruptured Intracranial Aneurysms in China".

颅内动脉瘤具有高发病率及低破裂率、高致残率的特点，其防治工作已成为公共卫生保健难题。但如何提高破裂动脉瘤所致蛛网膜下腔出血的诊断与治疗规范率，减少治疗延误；如何对未破裂颅内动脉瘤的治疗干预时机和方式获益—风险进行预测及个体化治疗仍是目前困扰临床医生、影响临床疗效的主要瓶颈。因此本研究的目标是通过颅内动脉瘤的系列研究，探索研究规范化的破裂动脉瘤早期诊疗模式，形成多维度的UIA破裂风险评估及临床治疗决策体系，并进一步探讨抗栓治疗对UIA破裂风险及预后的影响，从而形成适合国情的综合性动脉瘤诊疗适宜技术体系。具体研究内容及技术路线如下:1.颅内破裂动脉瘤规范化诊治模式建立与评估。2.UIA自然转归与干预治疗研究。3.UIA破裂风险预测模型。4.合并缺血性心脑血管病事件的UIA抗栓治疗规范化方案。 综上，本项目着力于建立颅内动脉瘤急救绿色通道及早期治疗规范，形成适合国情的破裂颅内动脉瘤治疗适宜技术；通过大样本队列研究及多中心大数据分析，明确国人UIA的年出血率及干预治疗决策系统，形成多维度预测模型，实现对UIA破裂风险的精准预测；并进而规范UIA合并缺血性心脑血管病事件的抗栓治疗方案。通过上述系列研究，推动动脉瘤性蛛网膜下腔出血及 UIA 的诊疗规范化，在避免不必要医疗干预的同时，提高手术安全性及疗效，具有深远社会效益和显著的卫生经济效益。 Intracranial aneurysm has the characteristics of high incidence,low rupture rate and high disability rate.The prevention and treatment has become a public health problem.However,how to improve the standardized diagnosis and treatment of aneurysmal subarachnoid hemorrhage,reduce the delay of treatment,balance the benefit and risk,apply individualized treatment and optimize the strategy of unruptured intracranial aneurysms still remain puzzles of clinicians.Therefore,we aimed to explore the standardized early-stage diagnosis and treatment strategy of ruptured aneurysm and assess the UIA rupture risk with a multi-dimensional model and clinical treatment decision-making system,and to further explore the impact of antithrombotic treatment on the rupture risk and prognosis of UIA,so as to reach a consensus on comprehensive and rational diagnosis and treatment system suitable for national conditions.The specific research content are as follows:1.Establishment and evaluation of standardized diagnosis and treatment mode of intracranial ruptured aneurysm.2.UIA natural course and intervention.3.prediction model of UIA rupture risk.4.Standardized UIA antithrombotic therapy with ischemic cardio-cerebrovascular events. This project focuses on the establishment of the first-aid green channel and early-stage treatment protocols for intracranial aneurysm,and appropriate technology for the treatment of ruptured intracranial aneurysm suitable for national conditions;with the assistance of large sample cohort study and multi-center big data analysis,the annual bleeding rate of UIA in China and the intervention and treatment decision-making system would be defined,a multi-dimensional prediction model would be summarized,and the accurate prediction of UIA rupture risk be realized;and To standardize the antithrombotic therapy of UIA combined with ischemic cardio cerebrovascular disease.Through the above series of studies,we can promote the standardization of diagnosis and treatment of aneurysmal subarachnoid hemorrhage and UIA,improve the safety and efficacy of surgery while avoiding unnecessary medical intervention,which has far-reaching social benefits and significant health and economic benefits.