StanfordB型主动脉夹层118例临床分析

Clinical features of 118 type B aortic dissection cases

目的研究StanfordB型主动脉夹层（BAD）患者的临床特征及其对预后的影响。方法回顾性分析118例患者的临床资料，统计患者的性别、年龄、主诉、既往主要病史、人院时的血压和心率以及住院期间转归。结果该组病例男性104例，女性14例；平均年龄（52．1±12．9）岁；61．9％的患者有胸痛主诉，71．2％的患者合并高血压病史；入院时平均心率（81．3±14．2）次／min，血压（156．0±34．7／91．9±21．2）mmHg；入院时收缩压≤100mmHg或〉160mmHg死亡率高（P〈0．05）；死亡组发病年龄[（41．0±7．8）岁]较存活组[（53．1±12．8）岁]低（P〈0．05）；入院时心率[（97．1±18．9）次／min]较存活组[（80．0±13．0）次／min]高（P〈0．05）；总体死亡率7．6％。Logistic回归分析发现，心率和年龄是预测死亡的独立指标。结论国内BAD患者发病平均年龄52岁。死亡患者平均年龄41岁，较存活组年轻；平均心率97次／min，较存活组快17次／min。收缩压≤100mmHg或≤161mmHg是死亡的高危人群。

Objective To study the clinical features of type B aortic dissection and their influence on the prognosis. Methods Clinical features including sex, age, main complaint, the past history, blood pressure and heart rate on admission and in - hospital outcome of 118 type B aortic dissection patients were retrospectively analyzed. Results One hundred and four males and fourteen females were included with mean age （52.1 ± 12.9） years. 61.9% of all complained of chest pain and 71.2% of all had hypertension history. On admission, the mean heart rate was （81.3 ± 14.2） beats per minute and the mean blood pressure was （ 156.0 ±34.7 ）/（91.9 ± 21.2） mm Hg. The patient whose systolic blood pressure≤ 100 mm Hg or 〉 160 mm Hg had a higher mortality than others （P 〈0.05 ） ; The mean age of death cases was younger than that of survived patients （ P 〈 0.05 ）, but the mean heart rate of death cases was faster than that of survived patients （ P 〈 0.05 ）. Logistic regression showed that age and heart rate were independent predictor of death. Conclusion As for Stanford type B aortic dissection, the mean age of Chinese patients was 52 years old, and the mean age of died cases, 41 years old, was younger than survived patients. The mean heart rate of died cases ,97 beats/minute,was faster （about 17 beats/minute） than survived patients. The patients had a systolic blood pressure ≤ 100 mm Hg or ≥ 161 mmHg were in highly dangerously group.