主动脉夹层患者临床特征及预后分析（附52例报告）

目的探讨主动脉夹层（AD）患者的临床特征以及预后分析。方法收集本院2006年1月至2010年9月间确诊为AD患者52例的临床资料，分析其临床易患因素，同时观察住院期问与死亡预后有关的危险因素。结果52例AD患者中男女性别之比2．0：1，平均年龄（53．5±10．6）岁，急性期院内病死率15．4％；急性AD患者收缩压、低密度脂蛋白、超敏C反应蛋白水平，以及高血压病患病率明显高于对照组（P〈0．05），其死亡相关因素如性别（男性）、舒张压、马凡综合征、超敏C反应蛋白水平，DeBakey并发意识障碍或心包填塞症状，死亡与存活患者之间差异有统计学意义（P〈0．05）；手术＋支架治疗病死率低（13％vs75％）。结论主动脉夹层患者临床特征有不同程度的差异；其舒张压、超敏C反应蛋白水平、De—Bakey并发意识障碍、心包填塞是导致患者急性期院内死亡的独立危险因素，手术或支架治疗是较为安全和有效的方法。

Objective To analyze the clinical features and prognostic analysis of patients with aortic dissection. Methods Retrospective analysis of their clinical features and risk factors for susceptibility were conducted on clinical data of 52 patients with aortic dissection from January 2006 to September 2010 in our Hosipital, while observing the prognosis during hospitalization and death - related risk factors. Results Among 52 cases with AD, the male/female ratio was 2. 0 ： 1. the mean age was（ 53.5 ± 10.6） years old, the intrahospital mortality was 15.4 in overall patients. Systolic blood pressure, as well as the incidence of hypertension was significantly higher（ P 〈 0. 05 ） , their death - related factors such as gender （male） , diastolic blood pressure, Marfan syndrome, high - sensitivity C - reactive protein levels, Debakey type, concurrent disturbance of consciousness and symptoms of pericardial tamponade were significant difference between death and survival （ P 〈 0. 05 ） ; the mortality rate is low （ 13 % vs75 % ） by surgery or stent. Conclusions Clinical features of aortic dissection in patients with varying degrees of difference; diastolic blood pressure, high - sensitivity C - reactive protein levels, disturbance of consciousness, tamponade were the independent risk factors of the mortality of AD in acute phase ; patients with AD could be effectively and safely treated by surgery or stent.