急性Stanford A型主动脉夹层患者术前主动脉弹性与术后主动脉重构的相关性  

Correlation between preoperative ascending aortic elasticity and postoperative aortic remodeling in patients with acute Stanford type A arotic dissection

作　　者：李金平 杜恩慧 关文华 LI Jinping;DU Enhui;GUAN Wenhua(Department of Radiology,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,Henan Province,China;The Third Clinical College of Xinxiang Medical University,Xinxiang 453003,Henan Province,China)

机构地区：[1]新乡医学院第三附属医院放射科,河南新乡453003 [2]新乡医学院第三临床学院,河南新乡453003

出　　处：《新乡医学院学报》2022年第3期222-227,共6页Journal of Xinxiang Medical University

基　　金：河南省医学科技攻关计划联合共建项目(编号:2018020378)。

摘　　要：目的探讨急性Stanford A型主动脉夹层(ATAAD)患者术前主动脉弹性与术后主动脉管腔重构的相关性。方法选择2011年1月至2020年6月于新乡医学院第三附属医院行急诊手术治疗且术后进行规律计算机断层扫描血管造影(CTA)随访的39例ATAAD患者为研究对象,依据术后3个月CTA计算患者术前升主动脉弹性参数主动脉扩张度(AD)、主动脉顺应性(AC)、主动脉僵硬度(ASI),依据术后末次CTA评估患者主动脉重构状态和假腔状态,依据主动脉重构状态将患者分为主动脉重构阳性组和主动脉重构阴性组,依据假腔状态将患者分为假腔内完全血栓形成组(A组)、假腔完全通畅组(B组)、假腔内不完全血栓形成组(C组)、假腔完全消失组(D组),分析AD、AC、ASI与主动脉重构状态和假腔状态的相关性。结果主动脉重构阳性31例(79.5%),主动脉重构阴性8例(20.5%)。主动脉重构阳性组患者AD、AC、ASI显著低于主动脉重构阴性组(P<0.05);Pearson相关性分析显示,AD、AC、ASI与主动脉重构阳性呈中度相关(r=0.664、0.569、0.514,P<0.05)。A组、B组、C组、D组患者主动脉弹性相关参数AD、AC、ASI比较差异有统计学意义(F=9.581、17.954、8.637,P<0.05)。B组患者AD、AC显著高于A组、C组和D组(P<0.05);A组、C组和D组患者的AD、AC比较差异无统计学意义(P>0.05)。B组和C组患者的ASI显著高于A组和D组(P<0.05);B组与C组、A组与D组患者ASI比较差异无统计学意义(P>0.05)。Pearson相关性分析显示,AD、AC、ASI与不同假腔状态之间无相关性(r=-0.145、-0.035、-0.196,P>0.05)。结论ATAAD患者术前升主动脉弹性对术后主动脉重构存在影响,但对假腔状态无明显影响,术前升主动脉弹性参数AD、AC、ASI对ATAAD治疗措施的制定具有参考价值,并对ATAAD的预后有一定预测价值。Objective To investigate the correlation between the preoperative ascending aortic elasticity and postoperative aortic remodeling in patients with acute Stanford type A aortic dissection(ATAAD).Methods A total of 39 patients with ATAAD who underwent emergency surgery and were followed up by regular computed tomography angiography(CTA)at the Third Affiliated Hospital of Xinxiang Medical University from January 2011 to June 2020 were selected as the research subjects.The preoperative elastic parameters of ascending aorta including the aortic dilatation(AD),aortic compliance(AC)and aortic stiffness(ASI)were calculated according to the CTA at three months after operation.The aortic remodeling status and false lumen status of patients were evaluated based on the last postoperative CTA.According to aortic remodeling status,the patients were divided into positive aortic remodeling group and negative aortic remodeling group;and according to the false lumen status,the patients were divided into complete thrombosis of false lumen group(group A),complete patency of false lumen group(group B),incomplete intraluminal thrombosis of false lumen group(group C)and complete disappearance of false lumen group(group D).The correlations between AD,AC,ASI and aortic remodeling and false lumen were analyzed.Results Aortic remodeling was positive in 31 cases(79.5%),and aortic remodeling was negative in 8 cases(20.5%).The values of AD,AC and ASI in the positive aortic remodeling group were significantly lower than those in the negative aortic remodeling group(P<0.05);Pearson correlation analysis showed that the values of AD,AC,ASI were moderately correlated with the positive aortic remodeling(r=0.664,0.569,0.514;P<0.05).The values of AD,AC and ASI were significantly different among the group A,group B,group C and group D(F=9.581,17.954,8.637;P<0.05).The values of AD and AC in the group B were significantly higher than those in the group A,group C and group D(P<0.05);there was no significant difference in the values of AD and AC among the

关 键 词：急性Stanford A型主动脉夹层 CT血管成像 主动脉重构 主动脉弹性 

分 类 号：R445.3[医药卫生—影像医学与核医学] R654.3[医药卫生—诊断学]