青年主动脉夹层临床分析  

Clinical analysis of aortic dissection in young patients

作　　者：郑智[1] 查正彪[1] 刘纯[1] 李利艳[1] 魏翔[1] 潘友民[1] ZHENG Zhi;ZHA Zhengbiao;LIU Chun;LI Liyan;WEI Xiang;PAN Youmin(Department of Cardiothoracic Surgery,Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院心脏大血管外科,430030

出　　处：《心肺血管病杂志》2020年第9期1090-1092,1115,共4页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:回顾性分析青年主动脉夹层14年来发病的临床特点和治疗变迁的情况。方法:收集我院2006年至2019年,年龄<45岁的青年主动脉夹层患者临床资料,按时间跨度平均分为两组:第一时间段2006年1月至2012年12月,第二时间段2013年1月至2019年12月。统计两时间段的临床资料并进行比较分析。结果:病例总数518例,其中第一时间段152例,第二时间段366例。下列指标的比例在第二时间段明显高于第一时间段:首诊时知晓高血压病史的比例(62.6%vs.45.4%,P<0.01);BMI≥32 kg/m^2重度肥胖的比例(12.9%vs.6.0%,P<0.05);腹围男性>110 cm,女性>100 cm,重度腹型肥胖的比例(24.7%vs.13.4%,P<0.01);血脂异常的比例(17.8%vs.10.1%,P<0.05);痛风或高尿酸血症的比例(15.8%vs.9.2%,P<0.05)。临床治疗方案中,保守治疗比例第二时间段明显低于第一时间段(13.4%vs.25%,P<0.05),第二时间段的在院病死率稍低于第一时间段(9.8%vs.13.2%),但差异无统计学意义(P>0.05)。结论:青年主动脉夹层发病的临床特点随时代变化,大众健康教育和治疗手段的进步是主动脉夹层防治中的关键。Objective:To demonstrate the changing trend of clinical characteristics and management of aortic dissection in fourteen years.Methods:Clinical data of aortic dissection patients(age<45 years old)were collected from 2006 to 2019.Patients were divided into two groups by time interval(group one from January 2006 to December 2012,group two from January 2013 to December 2019).Clinical data were compared between groups.Results:A total of 518 patients were recruited in this study.Among them,there were 152 patients in group one and 366 in group two.The proportion of the following clinical data was significantly higher in group two than that in group one:awareness of medical history of hypertension at first admission(62.6%vs.45.4%,P<0.01),severe obesity with BMI≥32 kg/m^2(12.9%vs.6.0%,P<0.05),huge abdominal circumference with>110 cm in male or>100 cm in female(24.7%vs.13.4%,P<0.01),hyperlipaemia(17.8%vs.10.1%,P<0.05),hyperuricemia(15.8%vs.9.2%,P<0.05).The proportion of conservative treatment was significantly lower in group two than that in group one(13.4%vs.25%,P<0.05).Mortality was slightly lower in group two than that in group one(9.8%vs.13.2%),but the difference was not significant(P>0.05).Conclusions:The clinical characteristics of aortic dissection in young patients are changing with time.Public health education and improvement of treatment are crucial to prevention and management of aortic dissection.

关 键 词：主动脉夹层 青年 临床资料 回顾性分析 

分 类 号：R54[医药卫生—心血管疾病]