腹主动脉瘤附壁血栓分布规律和相关因素分析  

Intraluminal thrombus in abdominal aortic aneurysms: distribution and influential factors in its formation

作　　者：梅志军[1] 景在平[1] 包俊敏[1] 赵志青[1] 左长京[1] 冯翔[1] 赵珺[1] 

机构地区：[1]第二军医大学长海医院,上海200433

出　　处：《解放军医学杂志》2004年第7期591-593,共3页Medical Journal of Chinese People's Liberation Army

基　　金：军队杰出人才基金 (编号 98J0 0 5);上海市卫生系统"百人计划"培养基金 (编号 97BR0 4 7)资助课题

摘　　要：目的　研究腹主动脉瘤 (AAA)附壁血栓 (ILT)的生长规律 ,探讨ILT与年龄、性别、AAA直径的关系。方法　对 10 3例AAA连续病例行CT扫描 ,观察有无ILT及ILT的分布规律 ,测量AAA直径和ILT最大厚度 ,分析ILT与年龄、性别及动脉瘤大小的关系。结果　6 6 9%AAA有ILT ,女性AAA有ILT较少见 (15 4 % )。ILT与AAA直径、患者年龄相关 ,AAA直径小于 4 0mm时形成ILT的比例为 2 1 4 % ,年龄小于 6 0岁时形成ILT的比例为 2 5 0 %。以近端瘤颈截面的中心和髂动脉分叉做一连线 ,血栓总是分布在距离该轴线较远的瘤壁。结论　瘤体内血流可能是ILT形成的重要因素 ;女性和年龄小于 6 0岁不易形成血栓 。Objective To investigated the distribution of intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs), and to examine the influence of age, gender and aneurysm diameters on the ILT formation. Methods Morphological analysis of ILT in AAA of 103 consecutive patients was undertaken with helical CT angiography. ILT shape, distribution and thickness of ILT were recorded and analyzed in correlation with age, gender and aneurysm diameters. Results ILT were found in 66.9% of all the patients. ILT was always situated in the area away from the main axis of AAA. The incidence of ILT in female group (n=13) was much lower than that in male group (n=90) (15.5% vs 77.4%, P<0.01). Patients who were younger than 60 years (n=12) had lower frequency of ILT formation (25.0%). AAA with diameter less than 40mm (n=14) also had a lower incidence of ILT (21.4%), while no statistical differences were found in those with AAA diameters over 40mm. The thickness of ILT increased with increase in AAA diameter. Conclusion The location of ILT might be mainly determined by blood flow. The relatively lower incidence of ILT in female and young patients indicated the multifactorial pathogenesis of ILT.

关 键 词：主动脉瘤 腹 附壁血栓 体层摄影术 X线计算机 

分 类 号：R543.16[医药卫生—心血管疾病]