胸主动脉瘤和胸主动脉夹层治疗进展

Advances in treatment for thoracic aortic aneurysm and thoracic aortic dissection

胸主动脉瘤和胸主动脉夹层是严重的心血管疾患。胸主动脉瘤和胸主动脉夹层的危险因素包括引起动脉退行性变的因素和增加动脉张力的因素。马凡综合征、Loeys-Dietz综合征、埃-当综合征、主动脉炎症病变、特纳综合征、主动脉二瓣畸形、家族性胸主动脉瘤和胸主动脉夹层等可造成主动脉中膜的变性。高血压、嗜铬细胞瘤、吸毒、外伤、举重、吸烟、心脏手术史等可增加动脉张力或引起动脉损伤。诊断胸主动脉瘤和胸主动脉夹层的主要方法为超声心电图、CT、磁共振。药物治疗包括肾上腺素β受体阻滞药、血管紧张素Ⅱ受体1拮抗药、血管紧张素转换酶抑制药、他汀类药物,对危重患者需行介入治疗或手术治疗。

Thoracic aortic aneurysm and thoracic aortic dissection are severe cardiovascular diseases. The risk factors for thoracic aortic aneurysm and thoracic aortic dissection are conditions that cause the degeneration of aorta and conditions that cause increase of aortic wall stress. Marfan syndrome, Loeye- Dietz syndrome,Ehlers- Danlos syndrome, inflammatory diseases of the aorta, Turner syndrome, bicuspid aortic valve, familial thoracic aortic aneurysm and dissection syndrome may cause aorta medial layer degeneration. Hypertension,pheochromocytoma, cocaine use, trauma, weight lifting, smoking, cardiac surgery may increase aorta wall tension or induce aorta injury. The main methods for diagnosis of thoracic aortic aneurysm and thoracic aortic dissection are echocardiography, computed tomography and cardiac magnetic resonance. Drug treatments include adrenaline beta- blockers, angiotensin Ⅱ receptor 1 antagonists, angiotensin converting enzyme inhibitors,statins. Surgery therapy or interventional therapy is necessary for severe or urgent patients.