老年人腹主动脉瘤的临床观察

Clinical features of abdominal aortic aneurysm in the elderly

目的观察老年腹主动脉瘤患者的临床特征。方法对60岁以上老年腹主动脉瘤患者进行回顾性分析，根据超声随访结果，了解腹主动脉瘤的自然发展情况，分析患者年龄和瘤体大小对动脉瘤增长的影响。结果78例患者多存在吸烟、高血压、高胆固醇血症、动脉粥样硬化等危险因素，20例并存其他部位动脉瘤（占25．6％）；瘤体破裂发生在动脉瘤较大、生长速度较快的患者。64例患者接受每年1次的超声随访，动脉瘤瘤体平均年增长0.14cm；在60-69岁、70-79岁、80-89岁、90-100岁4个年龄阶段，瘤体平均年增长0．14-0．18cm，各年龄间差异无统计学意义（P〉0．05）；当动脉瘤体直径〈3．0cm、3.0-4．9cm、≥5．0cm时，瘤体平均年增长分别为0．13cm、0．09cm、0．46cm，后者较前两者明显增加，差异有统计学意义（P〈0.01）。结论年龄不是老年人腹主动脉瘤增长快慢的影响因素；当瘤体直径小于5．0cm时，腹主动脉瘤随增龄增长缓慢，≥5．0cm时，随增龄增长快，破裂发生率增加，应行积极干预治疗。

Objective To observe the clinical features of abdominal aortic aneurysm（AAA） in the elderly. Methods Seventy-eight elderly eases with AAA were studied retrospectively, the effect of age and AAA size on the growth of AAA were analyzed. Results Risk factors such as smoking, hypertension, hypercholesteremia and artherosclerosis were found in most patients. Aneurysm in other side was found in 25.6% of the patients. Rupture occurred in patients with a larger in size or rapidly developing AAA. The average AAA diameter increase was 0.14 cm/year and it was similar for each age grade. When the AAA diameter was wider than 5 cm, it developed faster, and the growth velocity increased to 0.46 cm/year. Conclusions Age is not a risk factor that affects the development of AAA. If the AAA diameter is ≥5 cm, the AAA develops quickly, then active interventions are recommended.