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|本期目录/Table of Contents|

老年女性Stanford B 型主动脉夹层腔内隔绝术患者的临床特征

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2012年第4期
页码:
486-489
栏目:
临床研究
出版日期:
2012-08-25

文章信息/Info

Title:
Clinical features of elderly female patients with Stanford B aortic dissection managed with endovascular intervention
作者:
孙鸣宇; 韩雅玲; 王效增; 荆全民; 王祖禄
(沈阳军区总医院心内科 全军心血管病研究所，辽宁 沈阳 110016)
Author(s):
SUN Ming-yu;  HAN Ya-ling;  WANG Xiao-zeng;  JING Quan-min;  WANG Zu-lu
(Department of Cardiology, Shenyang General Hospital & PLA Cardiovascular Research Institute, Shenyang 110016, Liaoning, China) )
关键词:
主动脉疾病; 主动脉夹层; 女性; 老年
Keywords:
aortic disease;  aortic dissection;  female;  elderly
分类号:
R543.1
DOI:
-
文献标识码:
A
摘要:
目的:总结分析老年女性Stanford B 型主动脉夹层(aortic dissection,AD)腔内隔绝术患者的临床特征。方法： 2002年4月~2011年7月入住沈阳军区总医院并接受主动脉腔内隔绝术治疗且年龄≥60岁的Stanford B型AD患者，按性别分为老年男性组（61例）及老年女性组（30例）。年龄分别为（67±5）岁和（66±5）岁。对两组患者的临床特征、住院期间及随访结果进行回顾性分析。结果： 老年女性组已知高血压病史比例低于老年男性组，入院首诊高血压病比例高于老年男性组（均P<0.05）。但两组患者高血压病及穿透性动脉粥样硬化性溃疡的病因构成比并无统计学差异。老年女性组从出现症状到就诊时间≥24 h者比例高于老年男性组（P<0.05）。老年女性患者表现为突发疼痛比例低于老年男性患者（P<0.05）。其他患者特征、主要并发症、临床表现、病变情况、手术成功率、手术并发症及随访情况和随访结果均无显著差异。结论： 老年女性患者对高血压病的知晓率低，较少表现为突发性疼痛，就诊较晚。
Abstract:
AIM:To summarize the clinical features of elderly female patients with Stanford B aortic dissection. METHODS: Clinical features and hospital outcomes and during follow-up were retrospectively analyzed in both groups: elderly male patient group (≥60 years, n=61) and elderly female patient group (≥60 years, n=30) who suffered from Stanford B aortic dissection and were treated with endovascular intervention between April 2002 and July 2011. Average ages were (67±5) and (66±5) years, respectively. RESULTS: Average ages and proportion of patients’ ≥70 years were similar in both groups. No statistical differences were found between groups in the proportions according to smoking history, diabetes mellitus, coronary artery disease and hyperlipemia. In the group of elderly female patients, the rate of known hypertension was lower and the rate of first-time diagnosis of hypertension was higher than those in the elderly male group (P<0.05). No statistical differences were observed between groups in the constituent ratios of etiology including hypertension and penetrating atherosclerotic ulcer. The rate of hospital visit ≥24 h from the appearance of symptoms was higher in the group of elderly females than that in elderly male group (P<0.05). There were no statistical differences between groups in the incidences of chest/back pains, gastrointestinal upset, lower limb pain, dyspnea, hemoptysis, apopsychia, complications of hemothorax, cardiac or renal insufficiency, and hypoxemia. The group of elderly female patients presented less frequently with abrupt onset (P<0.05). The success ratio of endovascular therapy was 100% in the two groups. Lengths and diameters of aorta covered by stent grafts, incidences of endovascular leakage, postimplantation syndrome (transient elevations of body temperature and C-reactive protein and mild leukocytosis) and incisional infections showed no statistical differences between groups. One elderly male patient died due to aortic dissection and no deaths occurred in the group of elderly female patients during hospitalization. No statistical differences between groups were seen in hospital mortality as well as total mortality and mortality related to aortic dissection during follow-up. CONCLUSION: The group of elderly female patients with Stanford B aortic dissection is characterized by a lower rate of known hypertension and abrupt onset and later appearance. Better understanding of these clinical features will contribute to earlier diagnosis, more appropriate therapeutic options and, as a consequence, better outcome.

参考文献/References

[1]Malacrida R,Genoni M,Maggioni AP,et al.A comparison of early outcome of acute myocardial infarction in women and men[J].N Engl J Med,1998, 38(1):8-14.

[2]Vakili BA,Kaplan RC,Brown DL.Sex-based differences in early mortality of patients undergoing primary angioplasty for first acute myocardial infarction[J].Circulation,2001,104(25):3034-3038.

[3]Wassertheil-Smoller S,Anderson G,Psaty BM,et al.Hypertension and its treatment in postmenopausal women:baseline data from the Women’s Health Initiative[J].Hypertension,2000,36(5):780-789.

[4]Lloyd-Jones DM,Evans JC,Levy D.Hypertension in adults across the age spectrum: current outcomes and control in the community[J].JAMA,2005,294(4):466-472.

[5]Golledge J,Eagle KA.Acute aortic dissection[J]. Lancet,2008,372(9632):55-66.

[6]Pretre R,von Segesser LK.Aortic dissection[J].Lancet,1997, 349(9063):1461.

[7]张 健,景在平.AD病因学分析[J].外科理论与实践,2007,12(1):84-86.

[8]Neuhauser B,Greiner A,Jaschke W,et al.Serious complications following endovascular thoracic aortic stent-graft repair for type B dissectionl[J].Eur J Cardiothorac Surg,2008,33(1):58-63.

[9]Barton M,Meye MR.Postmenopausal Hypertension:mechanisms and therapy[J].Hypertension,2009,54(1):11-18.

[10]Nienaber CA,Fattori R,Mehta RH,et al.Gender-related differences in acute aortic dissection[J].Circulation,2004,109(24):3014-3021.

[11]Mehta RH,Bossone E,Evangelism A,et al.Acute type B aortic disseetion in elderly patients:clinical features,outcomes, and simple risk stratification rule[J].Am Thorae Surg,2004,77(5):1622-1628.

[12]Patel PD,Arora RR.Pathophysiology,diagnosis,and management of aortic dissection[J].Ther Adv Cardiovasc Dis,2008,2(6):439-468.

备注/Memo

备注/Memo:
收稿日期：2011-12-22.通讯作者：韩雅玲，主任医师，主要从事冠心病介入治疗研究 Email：hanyal@mail. sy. ln. cn 作者简介：孙鸣宇，主治医师，硕士Email：sunmingyu1976@126.com
更新日期/Last Update: 2012-07-20