青年急性主动脉夹层患者的性别差异

Analysis of gender-related differences in young patients with aortic dissection

目的分析青年主动脉夹层在致病危险因素、临床表现和治疗等方面的性别差异性。方法收集2006~2019年我院青年急性主动脉夹层患者,统计比较不同性别间的临床资料并分析性别差异性。结果本组病例共518例,其中男性431例(83%),女性87例(17%)。男性在下列指标中的比例均显著高于女性:高血压病史知晓率(62%vs.38%,P<0.01)、吸烟(50%vs.13%,P<0.01)、饮酒(15%vs.7%,P<0.05),巨大腹围(23%vs.9%,P<0.01)、Stanford A型(54%vs.40%,P<0.05)、心包填塞(14%vs.6%,P<0.05)及呼吸系统并发症(18%vs.9%,P<0.05)。在体质量指数(BMI)≥32、血脂异常、痛风、累及冠脉、肠系膜上动脉缺血、下肢缺血、保守治疗、循环系统并发症、神经系统并发症、肾功能并发症及在院病死率等方面,男性与女性无显著性差异。结论青年主动脉夹层患者在危险因素、临床表现及治疗并发症方面存在性别差异性。

AIM To demonstrate gender-related difference in risk factors,clinical manifestation,and treatment of aortic dissection in young patients.METHODS Young patients with aortic dissection were enrolled in this study and clinical data were analyzed and compared between different genders.RESULTS A total of 518 patients were recruited in this study.Among them,there were 431 males(83%)and 87 females(17%).The proportion of the following clinical data was significantly higher in male than that in female:awareness of medical history of hypertension at first admission(62%vs.38%,P<0.01),smoking habit(50%vs.13%,P<0.01),alcohol abuse(15%vs.7%,P<0.05),huge abdominal circumference with>110 cm in male or>100 cm in female(23%vs.9%,P<0.01),type A dissection(54%vs.40%,P<0.05),cardiac tamponade(14%vs.6%,P<0.05)and respiratory complication(18%vs.9%,P<0.05).The difference in BMI≥32,hyperlipaemia,hyperuricemia,involvement of coronary artery,superior mesenteric artery ischemia,lower limb ischemia,conservative treatment,circulatory complication,neurologic complication,renal complication and mortality between male and female was not significant.CONCLUSION Gender-related difference in risk factor,clinical manifestation,and treatment does exist in young patients with aortic dissection.