青年主动脉夹层患者神经系统症状临床分析  

Clinical Analysis of Neurological Symptoms in Young Patients with Aortic Dissection

作　　者：曹贵方[1] 毕齐[1] 曹莉[1] 

机构地区：[1]首都医科大学附属北京安贞医院神经内科,北京市100029

出　　处：《中国全科医学》2013年第9期1059-1061,共3页Chinese General Practice

摘　　要：目的分析青年主动脉夹层患者神经系统症状的临床特点。方法选取2010年1月—2012年8月首都医科大学附属北京安贞医院住院的青年主动脉夹层患者316例,平均(36.0±6.3)岁。回顾性分析患者的一般资料(年龄分层、病因)、神经系统症状、体征、神经影像学资料及夹层分型情况。结果 (1)年龄:青年主动脉夹层患者中16～20岁10例,21～25岁18例,26～30岁33例,31～35岁55例,36～40岁109例,41～44岁91例。病因:175例与高血压相关,37例与马凡综合征相关,4例与创伤相关,4例与妊娠相关。(2)77例出现神经系统症状,占24.37%。以一侧下肢感觉障碍(含疼痛或麻木)最常见,占7.28%,其次为头晕(包含眩晕)、晕厥和下肢单瘫,分别占4.75%、3.80%和3.16%。2例以神经系统症状为首发症状,1例以晕厥起病,1例以眩晕起病。(3)A型患者神经系统症状发生率与B型患者比较,差异有统计学意义(χ2=9.964,P=0.002)。A型神经系统症状中昏迷发生率与B型比较,差异有统计学意义(χ2=4.502,P<0.05)。A型其他神经系统症状发生率与B型比较,差异均无统计学意义(P>0.05)。结论青年主动脉夹层患者合并神经系统症状常见,以单下肢感觉障碍最常见,其次为头晕、晕厥和下肢单瘫。A型患者更易出现,可能与脑缺血有关。Objective To summarize the characters of neurological symptoms in young patients with aortic dissec- tion. Methods 316 young patients with aortic dissection of Beijing Anzhen Hospital Affiliated to Capital Medical University between January 2010 and August 2012 were selected. The average age of the patients was （ 36. 0 ＋ 6. 3 ） years old. The clinical data including neurological symptoms, signs, and neuroimaging data were retrospectively analyzed. Results （ 1 ） There were 10 ca- ses aged between 16 and 20 years old, 18 cases aged between 21 and 25 years old, 33 cases aged between 26 and 30 years old, 55 cases aged between 31 and 35 years old, 109 cases aged between 36 and 40 years old, and 91 cases aged between 41 and 44 years old. The etiological factor related with hypertension were 175 cases, with marfan syndrome 37 cases, trauma 4 cases and pregnancy 4 cases. （2） 77 （24. 37% ） patients showed neurological symptoms. The most common symptom was single lower ex- tremity sensory disturbance （ accounting for 7.28% ）, then dizziness, syncope and lower extremity monoplegia （ accounting for 4. 75%, 3.80% and 3.16% respectively） . Two patients showed neurological symptoms as the first manifestations, including one with syncope and another with dizziness. （3） Type A aortic dissection patients were more likely to have neurologic manifesta- tions as compared to Type B artic dissection patients （30. 41% vs. 14. 75% ）, and the difference between them were statistically significant （X2 = 9. 964, P = 0. 002 ） . The frequency of coma in patients with type A aortic dissection was significantly higher than those with type B aortic dissection （ X2 = 4. 502, P 〈 0. 05） . No significant difference was observed in the incidence rate of other neurological symptoms between the two type patients （ P 〉 0. 05 ） . Conclusion Neurological symptoms are common in young patients with aortic dissection. The most common symptom is single lower extremity sensory disturbance, then dizziness, sync

关 键 词：主动脉夹层 神经病学表现 青年 分型 

分 类 号：R543.1[医药卫生—心血管疾病]