主动脉夹层患者神经系统症状的临床分析  

The clinical analysis of neurological symptoms in patients with aortic dissection

作　　者：曹贵方[1] 毕齐[1] 曹莉[1] 

机构地区：[1]100029首都医科大学附属北京安贞医院神经内科

出　　处：《中华内科杂志》2013年第5期400-402,共3页Chinese Journal of Internal Medicine

摘　　要：目的 总结主动脉夹层患者神经系统症状的特点.方法 对865例临床诊断为主动脉夹层的患者进行回顾性分析,包括临床症状、体征以及影像学资料.结果 225例（26.0％）患者出现神经系统症状,最常见症状为头晕（56例,6.5％）,其次为晕厥（49例,5.7％）,一侧下肢感觉障碍47例（5.4％）,单一下肢瘫27例（3.1％）,昏迷22例（2.5％）,截瘫19例（2.2％）,头痛13例（1.5％）,偏瘫9例（1.0％）.其中5例以神经系统症状为首发表现,包括晕厥2例,眩晕1例,头痛2例.A型主动脉夹层患者更易出现神经系统表现（34.6％比14.7％）,其中晕厥、昏迷、偏瘫、截瘫、下肢感觉障碍等症状的发生显著高于B型主动脉夹层.结论 主动脉夹层患者合并神经系统症状常见,A型主动脉夹层患者更常见.Objective To summarize the characteristics of neurological symptoms in patients with aortic dissection. Methods The clinical data including symptoms, signs, and imaging of 865 consecutive patients with aortic dissection were analyzed retrospectively. Results Neurological symptoms occurred in 225 cases （26. 0% ） with aortic dissection. The most common symptom was dizziness （56 cases, 6. 5% ） , followed by syncope （ 49, 5.7% ） , single lower limb sensory disturbances （ 47, 5.4% ）, single lower extremity weakness （27, 3.1% ）, coma （22, 2. 5% ）, paraplegia （ 19, 2. 2% ） , headache （13,1.5 % ）and hemiplegia （ 9,1.0% ） . The first manifestation of five cases was the neurological symptoms, including syncope （2）, dizziness（ 1 ）and headache （2）. Patients with type A aortic dissection were more vulnerable to the neurological symptoms than those with type B aortic dissection （34. 6% vs 14.7% ）, and the symptoms with significantly higher occurrence were syncope, coma, hemiplegia, paraplegia and lower limb sensory disturbances. Conclusion Neurological symptoms are common in patients with aortic dissection, especially in those with type A aortic dissection.

关 键 词：主动脉瘤 神经系统 

分 类 号：R54[医药卫生—心血管疾病] R74[医药卫生—内科学]