主动脉夹层患者死亡的危险因素分析

Analysis of the Risk Factors of Death in Patients with Aortic Dissection

目的分析主动脉夹层患者死亡的危险因素分析,为降低主动脉夹层患者病死率作出指导。方法回顾性分析武汉亚洲心脏病医院2006年8月至2010年4月收治的571例主动脉夹层患者的临床资料,探讨各临床因素导致的病死率,并进行多因素分析,明确导致患者死亡的危险因素。结果单因素分析结果显示:不同Standford分型,有无家族心血管病史、吸烟史、并发症,及不同收缩压和治疗方式的病死率比较,差异有统计学意义(P<0.05);多因素非条件Logistic回归分析结果显示:Stanford分型A型、有家族心血管病史、有吸烟史、收缩压<90 mm Hg及行手术治疗方式是影响主动脉夹层患者死亡的独立危险因素(P<0.05)。结论 Stanford分型A型、有家族心血管病史、有吸烟史、收缩压<90 mm Hg及行手术治疗方式显著增加了主动脉夹层破裂的风险,是影响主动脉夹层患者病死的独立危险因素,对存在上述指征的患者应给予重点看护、治疗,以降低病死率,提高预后。

Objective To analyze risk factors of death in patients with aortic dissection, and make guid- ance to reduce the mortality. Methods The clinical data of 571 patients with aortic dissection in Wuhan Asia Heart Hospital from Aug. 2006 to Apr. 2010 were analyzed retrospectively ,the mortality resulted from different clinical factors was discussed, and multiple factor analysis was done to clarify risk factors leading to death. Results Single factor analysis showed that：Standford typing,family history of cardiovascular disease, smoking history, complications, systolic blood pressure and treatment methods have significant effects on mor- tality in patients with aortic dissection（ P 〈 0.05 ） ; non-conditional multivariate regression Logistic analysis showed that： Stanford type A, family history of cardiovascular disease, a history of smoking, systolic blood pressure 〈 90 mm Hg and operation treatment were the independent factors of death in patients with aortic dissection（ P 〈 0.05 ）. Conclusion Stanford type A, a family history of cardiovascular disease, a history of smoking,systolic blood pressure of 〈 90 mm Hg and the operation mode of treatment significantly increase the risk of rupture of aortic dissection, which are independent risk factors of death in patients with aortic dissection, and the existence of these indications should be administered with focus on care, treatment, in order to reduce the mortality and improve the prognosis.