75岁以上老年主动脉夹层伴OSAHS临床特点分析  

Clinical characteristics of aortic dissection complicated with obstructive sleep apnea hypopnea syndrome in over 75 years old patients

作　　者：别自东[1] 孙丽叶[4] 孟庆国[2] 王玉凤[1] 孙红艳[3] 

机构地区：[1]潍坊医学院附属文登中心医院心内科,264400 [2]潍坊医学院附属文登中心医院急诊科,264400 [3]潍坊医学院附属文登中心医院放射介入科,264400 [4]烟台市毓璜顶医院保健科,264000

出　　处：《国际医药卫生导报》2016年第4期514-518,共5页International Medicine and Health Guidance News

摘　　要：目的对老年主动脉夹层伴睡眠呼吸暂停综合征（OSAHS）患者的临床特征、危险因素、主动脉CTA结果及近期临床转归进行回顾性总结。方法入选老年主动脉夹层伴OSAHS患者30例及单纯主动脉夹层患者55例，抽血检测血生化、血脂，行主动脉CTA等及对病人行短期随访，对上述临床资料进行对比。结果老年主动脉夹层伴OSAHS组的体重指数、血脂异常、清晨高血压及周围血管病史均高于单纯主动脉夹层组（27．3±3．5）kg／m2 vs．（23．4±3．2）kg／m2，11（36．7％）vs．10（18．2％），23（76．7％）vs．30（54．5％）．10（33．3％）vs．8（14．5％），P〈0．05；与单纯主动脉夹层组比较，主动脉夹层伴OSAHS组血清甘油三酯、低密度脂蛋白胆固醇水平、血清同型半胱氨酸（Hcy）较高，血清胱抑素C（CysC）水平明显降低（2．76±1．24）mmol/L vs．（2．02±1．01）mmol/L，（2．70±0．83）mmol/L VS．（2．16±0．81）mmol／L，（14．2±3．1）umoL/ vs．（11．3±2．7）umol／L，（1．05±0．26）mg／L vs．（1．22±0．20）mg，L（P〈0．05）；与单纯主动脉夹层组比较，主动脉夹层伴OSAHS组主动脉钙化发生率及附壁血栓形成率高[24（80．0％）vs．32（65．5％）1，[14（46．7％）vs．13（23．6％）]，P〈0．05；与单纯主动脉夹层组比较，频发早搏、窦性心动过缓、肺部感染发病率高（[13（43.3％）vs．11（20．0％）]，[24（80．0％）vs．30（54．5％）]，[11（36．7％）vs．9（16．4％）1，P〈0．05。结论老年主动脉夹层伴OSAHS患者易出现清晨高血压、超重、血脂异常，其主动脉老化快，并且易于发生心律失常和肺部感染。Objective To explore the clinical features of of senile aortic dissection complicated with obstructive sleep apnea hypopnea syndrome （OSAHS）. Methods 55 senile patients with only aortic dissection and 30 with aortic dissection complicated OSAHS were selected. Blood was sampled from all the patients for the detection of biochemical indicators and lipids. CTA was carried out in all the patients. All the patients were followed up. The clinical data were compared. Results The body mass index, dyslipidemia, morning hypertension, and peripheral vascular disease history were higher in the senile patients with aortic dissection complicated OSAHS than in those with only aortic dissection [（27.3±3.5） kg/m2 vs. （23.4±3.2） kg/ m2, 11（36.7%） vs. 10 （18.2%）, 23（76.7%） vs. 30（54.5%）, and 10（33.3%） vs. 8（14.5%）, P 〈 0.05]. The levels of serum triglyceride, low-density lipoprotein cholesterol, and homocysteine （Hcy） were higher and serum Cystatin c （CysC） levels was significantly lower in the senile patients with aortic dissection complicated OSAHS than in those with only aortic dissection [（2.76±1.24）mmol/L vs.（2.02±1.01）mmol/L, （2.70±0.83）mmol/L vs.（2.16±0.81）mmol/L, （14.2±3.1）umol/L vs.（11.3±2.7）umol/L, and （1.05±0.26）mg/L vs.（1.22±0.20）mg/L,P 〈0.05）]. The incidences of aortic calcification, mural thrombus formation, frequent premature, sinus bradycardia, and pulmonary infection were higher in the senile patients with aortic dissection complicated OSAHS than in those with only aortic dissection[24（80.0%） vs. 32（65.5%）, 14（46.7%） vs. 13（23.6%）, 13 （43.3%） vs. 11（20.0%）, 24（80.0%） vs. 30（54.5%）, and 11（36.7%） vs. 9（16.4%）, P〉0.05]. Conclusions Senile patients with aortic dissection complicated with OSAHS prone to have high blood pressure in morning, overweight, dyslipidemia, aortic ageing fast, arrhythmias, and pulmonary infection.

关 键 词：主动脉夹层 老年 OSAHS 临床特点 

分 类 号：R543.1[医药卫生—心血管疾病]