腹主动脉瘤瘤体形态学指标与破裂的关系探讨  

Correlation between morphological indexes and rupture of abdominal aortic aneurysm

作　　者：俞慎林[1] 张济[1] 李光泽[1] 林昌俭 Yu Shenlin;Zhang Ji;Li Guangze;Lin Changjian(Department of Vascular Surgery,Leshan People's Hospital,Leshan 614000,China)

机构地区：[1]乐山市人民医院血管外科,四川乐山614000

出　　处：《中国血管外科杂志（电子版）》2021年第3期224-227,共4页Chinese Journal of Vascular Surgery(Electronic Version)

摘　　要：目的研究腹主动脉瘤(abdominal aortic aneurysm,AAA)直径、瘤体体积(total abdominal aortic aneurysm volume,TAV)与容积(abdominal aortic aneurysm volume,AAV)及瘤腔内血栓(intraluminal thrombus,ILT)厚度、ILT体积(intraluminal thrombotic volume,ILTV)等形态学指标与AAA破裂的关系。方法回顾性分析乐山市人民医院2015年1月至2020年1月收治的105例AAA患者的临床资料,根据瘤体是否破裂分为破裂组(36例)与无破裂组(69例),比较两组的AAA直径、TAV、AAV、ILTV和ILT厚度等数据,分析影响瘤体破裂的相关因素。结果多因素Logistic回归分析结果显示,TAV、ILTV、LIT厚度、AAA直径均是影响瘤体破裂的独立危险因素。绘制受试者工作特征曲线发现,各指标单独应用时以ILTV预测AAA破裂的效能最高[曲线下面积(area under curve,AUC)=0.884,95%CI=0.820~0.947,诊断灵敏度91.70%,诊断特异度81.20%],其次依次是TAV(AUC=0.758,95%CI=0.664~0.852)和ILT厚度(AUC=0.686,95%CI=0.569~0.802),AAA直径预测效能最低(AUC=0.630,95%CI=0.514~0.746,诊断灵敏度55.60%,诊断特异度72.50%)。结论ILTV、ILT厚度、TAV及AAA直径均是影响AAA破裂的独立危险因素,其中ILTV及TAV在预测AAA破裂中的效能更好。Objective To investigate the correlation between morphological indexes of abdominal aortic aneurysm(AAA)such as AAA diameter,total abdominal aortic aneurysm volume(TAV),abdominal aortic aneurysm volume(AAV),intraluminal thrombus(ILT)thickness and intraluminal thrombotic volume(ILTV)and rupture of AAA.Methods The clinical data of 105 AAA patients in Leshan People's Hospital from January 2015 to January 2020 were analyzed retrospectively.Patients were divided into ruptured group(36 cases)and non-ruptured group(69 cases)according to the presence or absence of ruptured AAA.We compared the data of AAA diameter,TAV,AAV,ILTV and ILT thickness of the two groups,and analyze the related factors of ruptured AAA.Results Multivariate Logistic regression analysis suggested that TAV,ILTV,LIT thickness and AAA diameter are independent risk factors of ruptured AAA.Receiver operating characteristic curve indicated that while each indicator was used alone,ILTV had the highest efficiency in predicting ruptured AAA[area under curve(AUC)=0.884,95%CI=0.820~0.947,and the diagnostic sensitivity was 91.70%,specificity was 81.20%],followed by TAV(AUC=0.758,95%CI=0.664~0.852)and ILT thickness(AUC=0.686,95%CI=0.569~0.802).AAA diameter had the lowest diagnostic efficacy(AUC=0.630,95%CI=0.514~0.746,and the diagnostic sensitivity was 55.60%,specificity was 72.50%).Conclusion ILTV,ILT thickness,TAV and AAA diameter are independent risk factors of ruptured AAA,and ILTV and TAV are more effective in predicting AAA rupture.

关 键 词：腹主动脉瘤 破裂 形态学 预测效能 

分 类 号：R543.16[医药卫生—心血管疾病]