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作 者:葛翼鹏[1] 里程楠[1] 钟永亮[1] 夏瑀[1] 肖付诚 胡海瓯[1] 郑铁[1] 朱俊明[1] 孙立忠[1] GE Yipeng;LI Chengnan;ZHONG Yongliang;XIA Yu;XIAO Fucheng;HU Haiou;ZHENG Tie;ZHU Junming;SUN Lizhong(Department of Cardiovascular Surgery, Beijing Anzhert Hospital, Capital Medical University, Beijing, 100029, P.R.China)
出 处:《中国胸心血管外科临床杂志》2019年第9期870-873,共4页Chinese Journal of Clinical Thoracic and Cardiovascular Surgery
基 金:北京市科技重大专项课题(Z171100001017083);心血管疾病精准医学北京实验室(PXM2017_014226_000037)
摘 要:目的通过主动脉 CTA 观察急性 Stanford A 型主动脉夹层肾动脉受累情况,并分析不同的肾动脉受累分型患者的肾脏功能是否存在差异。方法 2016 年 1 月至 2017 年 11 月,纳入151 例肾动脉受累的急性 Stanford A 型主动脉夹层患者,其中男 118 例、女 33 例,平均年龄(47.93±10.53)岁。根据主动脉血管造影将一侧肾动脉受累情况分为4型:A型,肾动脉开口附近内膜片大破口,辨别肾动脉起自真腔或者假腔困难;B 型,肾动脉完全起自假腔;C 型,肾动脉完全起自真腔;D 型,肾动脉本身受夹层累及,肾动脉内可见内膜片。分析并比较不同双侧肾动脉受累分型患者的血肌酐和肌酐清除率。结果 One-way ANOVA 分析结果显示,各组血肌酐和肌酐清除率差异无统计学意义(P>0.05)。各组患者年龄、性别、高血压病史比例及发病时间差异均无统计学意义(P>0.05)。结论急性Standford A型主动脉夹层肾动脉受累最常见的三种类型依次为双肾动脉一侧起自真腔一侧起自假腔(BC 型),双肾动脉均起自真腔(CC 型),双肾动脉一侧肾动脉附近内膜大破口而另外一侧起自真腔(AC 型)。肾动脉受累的程度不影响肾脏功能。Objective To evaluate the involvement of renal artery in acute Stanford type A aortic dissection (TAAD) using CT angiography (CTA) and to analyze the difference of renal function among different types of renal artery involvement. Methods From January 2016 to November 2017, 151 patients of acute TAAD with renal artery involvement were included in the study. There were 118 males and 33 females, with an average age of 47.93± 10.53 years. All patients underwent aortic CTA to confirm the TAAD. According to CTA, involvement of one side of renal artery can be divided into four types: type A, large tear near renal artery orifice, difficult to distinguish true or false lumen;type B, the orifice of the renal artery originates entirely from the false lumen;type C, the orifice of the renal artery originates entirely from the true lumen;type D, renal artery dissection is observed, renal artery intima can be seen. The levels of serum creatinine (sCr) and creatinine clearance (CC) in all groups were analyzed and compared. Results The results of one-way ANOVA analysis showed that there was no significant difference in sCr or CC among the groups (P>0.05). There was no significant difference in age, sex, proportion of hypertension history and onset time among the above groups (P>0.05). Conclusion The three most common types of renal artery involvement were BC type, CC type, and AC type. The types of renal artery involvement do not affect renal function.
关 键 词:急性Stanford A型主动脉夹层 肾动脉受累分型 肾脏功能
分 类 号:R543.1[医药卫生—心血管疾病]
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