腹主动脉瘤患者发病特点及影响其预后的相关因素  

Clinico-epidemiological features of infrarenal abdominal aortic aneurysm and relevant prognostic factors

作　　者：宋晋秋[1] 张健[1] 尹鸣镝[1] 吴彬[1] 单绍银[1] 段志泉[1] 辛世杰[1] 

机构地区：[1]中国医科大学附属第一医院普通外科教研室血管甲状腺外科,沈阳110001

出　　处：《中华医学杂志》2008年第23期1613-1617,共5页National Medical Journal of China

基　　金：国家自然科学基金资助项目（30471706）;辽宁省教育厅高等学校科研基金资助项目（20201344）

摘　　要：目的探讨腹主动脉瘤（AAA）发病的临床流行病学特点及影响预后的相关因素。方法回顾性分析中国医科大学附属第一医院1988-2007年收治的375例AAA患者临床资料，应用Cox比例风险回归模型分析各相关因素与预后的关系。结果肾下AAA患者共375例，患者平均年龄（62±15）岁。男性患者282例，女性93例，男女比例3．03：1。男性中破裂性AAA（14．5％）多于女性（6．5％）（P〈0．05），5年存活率男性组（65．7％）低于女性组（83．3％）（P〈0．01）；≥65岁组破裂率（3．6％）明显低于〈65岁组（17．7％）（P〈0．05），≥65岁年龄组5年生存率（80．4％）优于〈65岁组（64．2％）（P〈0．025）；非高血压组5年生存率（77．4％）优于高血压组（60．6％）（P〈0．05）。最近10年中国医科大学附属第一医院收治肾下AAA患者比前一个10年增加186．6％，且患者瘤体直径缩小（P〈0．01），但动脉瘤破裂发生率差异无统计学意义（P〉0．5）。应用Cox回归分析显示性别（P〈0．05）、入院前吸烟（P〈0．05）和高血压（P〈0．05）3个危险因素影响腹主动脉瘤患者预后；而年龄、治疗方式的选择等因素与AAA患者预后无明显相关性。结论AAA发病率呈上升趋势。男性、吸烟、高血压AAA患者不仅临床表现较为严重，而且预后较差；年龄、治疗方式的选择等因素与AAA患者预后无明显相关性。Objective To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm （AAA） and relevant prognostic factors. Methods The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged （62 ± 15）, hospitalized 1988 - 2007were analyzed. Results In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years The rupture rate of the male AAA patients was 14. 4%, significantly higher than that of the female AAA patients （6. 5%, P 〈0.05 ）. The rupture rate of the AAA aged patients ≥65 was 3.6%, significantly lower than that of the AAA patients 〈65 （17.7%, P 〈0. 01 ）. The aneurysm diameter of the patients with hyperextension was （6. 1 ± 3.3） cm, significantly lower than that of the patients without hypertension [ （6.8 ± 2. 3 ） cm. P 〈 0. 05 ]. The general 5-year survival rate was 70. 1%. The 5-year survival rates of the female patients, patients ≥ 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients 〈 65, and patients with hypertension or coronary heart disease （all P 〈 0. 05 ）. Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors （ all P 〈 0.05）. Conclusion The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.

关 键 词：主动脉瘤 腹 回顾性研究 危险因素 预后 

分 类 号：R686[医药卫生—骨科学]