急性主动脉夹层85例临床分析及其心电图表现特点  

Clinical analysis of 85 cases of acute aortic dissection and its electrocardiogram features

作　　者：宁兰兰[1] 刘超[1] 欧玉琼 魏宜霖[1] 刘玉琼[1] NING Lanlan;LIU Chao;OU Yuqiong;WEI Yilin;LIU Yuqiong(Department of Ultrasound and Electrocardiogram, Guangzhou First People s Hospital, Guangzhou 510180,China)

机构地区：[1]广州市第一人民医院

出　　处：《广州医药》2019年第5期21-24,共4页Guangzhou Medical Journal

摘　　要：目的分析急性主动脉夹层患者的临床特征、心电图表现特点及其与预后的相关性。方法回顾性分析2017年1月1日-2018年12月31日在我院就诊的85例急性主动脉夹层患者的临床资料,统计分析入院时心电图表现,比较Stanford A型与B型患者在临床特征与心电图表现的差异。结果所有患者平均年龄(54.9±13.4)岁,其中Stanford A型38(44.7%)例,Stanford B型47(55.3%)例。A型患者在入院时收缩压与舒张压低于B型患者;在发病症状为无明显疼痛的发生率A型低于B型患者。有完整心电图资料者55例,伴急性冠状动脉综合征样心电图表现者16(29.1%)例;A型患者伴急性冠状动脉综合征样心电图表现者较B组高[44%(11/25)vs 16.7%(5/30),P=0.026]。Stanford A型患者死亡率为28.9%;B型死亡率为10.6%;伴急性冠脉综合征样心电图表现者死亡率为43.8%(7/16),不伴急性冠脉综合征样心电图改变者死亡率10.2%(4/39),差异有统计学意义(P=0.014)。结论入院时的收缩压与舒张压水平较低者,心电图表现为急性冠脉综合征样改变者,A型夹层的可能性更大;A型夹层死亡率高,急性主动脉夹层患者伴急性冠状动脉综合征样心电图表现者死亡率高。Objective To analyze the clinical characteristics, electrocardiographic features and their prognosis correlation with acute aortic dissection. Methods The clinical data of 85 patients with acute aortic dissection admitted to our hospital from January 1, 2017 to December 31, 2018 were retrospectively analyzed. The electrocardiogram (ECG) performance on admission was statistically analyzed, and the difference in clinical characteristics and electrocardiogram performance between Stanford type A and type B patients was compared. Results The mean age of all patients was 54.9±13.4 years, including 38 cases of Stanford type A (44.7%) and 47 cases of Stanford type B (55.3%). Systolic and diastolic blood pressure of type A patients was lower than that of type B patients at admission. The incidence of no significant pain was lower in type A patients than that in type B patients. There were 55 cases with complete ECG data and 16 cases (29.1%) with acute coronary syndrome-like ECG performance. The ECG performance of type A patients with acute coronary syndrome was higher than that of group B[44%(11/25)vs.16.7%(5/30), P =0.026]. The mortality of patients with Stanford type A was 28.9%,with type B being 10.6%. Mortality was 43.8%(7/16) in patients with acute coronary syndrome-like ECG performance, and 10.2%(4/39) in patients without acute coronary syndrome-like ECG change, showing a statistically significant difference ( P =0.014). Conclusion Patients with low systolic and diastolic blood pressure on admission and acute coronary syndrome-like ECG performance are more likely to have type A dissection. The mortality of type A dissection was higher than that of type B, and the mortality of patients with acute aortic dissection accompanied by acute coronary syndrome-like electrocardiogram was higher than those without acute coronary syndrome-like electrocardiogram.

关 键 词：急性主动脉夹层 急性冠状动脉综合征样心电图改变 死亡率 

分 类 号：R540.41[医药卫生—心血管疾病] R543.1[医药卫生—内科学]