232例主动脉夹层相关危险因素分析  

Associated risk factors analysis of 232 cases of aortic dissection

作　　者：宋玮[1] 王爱萍[1] 闫文菊[1] 张普[1] 李惠娟[1] 丰伟[1] 杜波[1] 

机构地区：[1]山东省泰安市中心医院心内科,271000

出　　处：《中国综合临床》2016年第4期338-341,共4页Clinical Medicine of China

摘　　要：目的通过回顾性分析，研究分析主动脉夹层发病及死亡相关危险因素。方法采用回顾性研究，将该院收治并确诊的232例AD患者为病例组，依据Stanford分型：A型：夹层累及升主动脉（A组，91例）；B型：夹层未累及升主动脉（B组141例）。随机选取同期在该院因胸痛住院的并排除主动脉夹层患者为对照组。通过病史资料采集，分析年龄、性别、吸烟饮酒史、既往疾病史、心血管病家族史、发病诱因等与AD的发病的关系及A型与B型在危险因素之间的差异。在病例组中对部分相关因素进行单因素及多因素logistic回归分析。结果与对照组相比，病例组有吸烟史、高血压病史、冠心病病史、马凡综合征、高尿酸血症者高于对照组，差异具有统计学意义（χ2值分别为6．165、11．700、9．260、14．070、35．170，P均〈0．05）。A组马凡综合征、冠心病病史及高脂血症病史明显高于B组，在既往高血压病史上，B组显著高于A组，差异均有统计学意义（χ2值分别为3．998、4．534、7．308、7．827，P均〈0．05）。在校正其他因素的情况下，A型患者死亡的风险是B型的3．27倍（P〈0．001）；有高血压病史的患者是无高血压病史的患者发生死亡风险的1．48倍（P=0．014）；有低血压休克的患者是无低血压休克的患者发生死亡风险的2．27倍（P〈0．001）。结论吸烟史、高血压病史、冠心病病史、高尿酸血症者是主动脉夹层发病危险因素，A型主动脉夹层、有高血压病史、发病后出现低血压或心源性休克是导致主动脉夹层患者死亡独立危险因素。Objective To analyze the risk factors associated with morbidity and mortality of aortic dissection through the retrospective analysis. Methods Two hundred and thirty-two patients with aortic dissection（AD） who were treated in the Central Hospital of Taian were select as cases group, and were divided into A group of dissection involved ascending aorta with 91 cases and B group of dissection not involved ascending aorta with 141 cases according to type of Stanford. And 232 cases patients with chest pain in the same period of hospitalization and exclusion of aortic dissection were randomly selected as the control group. Through the history data collection, the relationship between age, sex, smoking and drinking history, history of previous illness, family history of cardiovascular disease, predisposing factors and the incidence of AD, and the difference of risk factors between A type and B type were analized. Single factor and multi factor Logistic regression analysis were performed on part of the related factors in the case group. Results Smoking history, hypertension history, coronary atherosclerotic heart disease history, Marfan syndrome and hyperuricemia of cases group were higher than of control group （ χ2 = 6. 165, 11. 700, 9. 260, 14. 070, 35. 170 ; P 〈 0. 05 ） . Marfan syndrome, coronaryatherosclerotic heart disease history and hyperlipidemia history of A group were higher than of B group, hypertension history of B group was higher than A group, and the differences were significant（ χ2 = 3. 998,4. 534, 7. 308,7. 827;P〈0. 05） . In the correction of other factors,the risk of death in patients with type A was 3.27 times that of the B type（ P〈0. 001 ） , the risk of death in patients with a history of hypertension were 1.48 times more than that without history of hypertension（ P= 0. 014） ,the risk of death in patients with hypotension shock were 2. 27 times more than that without hypotension shock （ P 〈 0. 001 ） . Conclusion History of smoking, history of hypertension, history of

关 键 词：主动脉夹层 危险因素 

分 类 号：R543.1[医药卫生—心血管疾病]