急性降主动脉夹层病情发生发展影响因素分析

ANALYSIS OF FACTORS INFLUENCING OCCURRENCE AND DEVELOPMENT OF ACUTE DESCENDING AORTIC DISSECTION

目的探究急性降主动脉夹层病情发生与发展的影响因素。方法选取2013年11月—2018年11月该院收治的急性降主动脉夹层患者40例为观察组,并同时选取40例健康体检个体为对照组,分析观察组所有患者临床资料,并将对照组相应指标与观察组进行单因素对比,将差异显著项进行Logistic回归分析,探究急性降主动脉发病影响因素;后观察组患者设为A组,2个月后入院随访检查设为B组,同样将检查结果做单因素对比分析,并将差异显著项进行Logistic回归分析,探究急性降主动脉病情发展影响因素。结果观察组和对照组基线资料单因素比较显示,观察组平均动脉压、D-二聚体以及血肌酣水平明显高于对照组,差异有统计学意义(P<0.05),其余项目二组比较差异无统计学意义(P>0.05);A组与B组基线资料比较显示,B组平均动脉压、D-二聚体水平、血肌酣水平、凝血酶原时间明显高于A组,心脏射血分数明显低于A组,差异有统计学意义(P<0.05),其余项目差异无统计学意义(P>0.05);根据观察组和对照组基线资料中单因素比较,纳入平均动脉压、D-二聚体以及血肌酐作自变量,进行Logistic回归分析,分析结果显示,平均动脉压与患者急性降主动脉夹层发生呈正相关(P=0.008,OR=1.480,95%CI=0.505~2.205),血肌酐与患者急性降主动脉夹层发生呈正相关(P=0.013,OR=1.626,95%CI=1.108~3.091),D-二聚体与患者急性降主动脉夹层发生未表现出相关性(P>0.05);根据A组和B组基线资料中单因素比较,纳入平均动脉压、D-二聚体、血肌酐以及凝血酶原时间作自变量,进行Logistic回归分析,分析结果显示,平均动脉压与患者急性降主动脉夹层发展呈正相关(P=0.035,OR=1.265,95%CI=1.017~1.574),血肌酐与患者急性降主动脉夹层发展呈正相关(P=0.011,OR=1.521,95%CI=1.101~2.101),凝血酶原时间与患者急性降主动脉夹层发展呈正相关(P=0.002,OR=12.468,95%CI=2.569~60.511),D-二聚体与患者急性降主动脉夹层发展未表现出相关性(P>0.05)。结论急性降主动脉夹层发生与发展影响因素较多,高血压在本研究中表现出较为明显正相关性,而糖尿病相关指标虽表现出一定相关性,但无法确定,相关研究需进一步开展,确保该类患者预后得到有效改善,提高诊断准确率与风险预测。

Objective To explore the influencing factors of the occurrence and development of acute descending aortic dissection.Methods In November 2013 to November 2018,forty patients with acute descending aorta dissection of Fuyang People’s Hospital for observation group,and at the same time to choose 40 cases of healthy check-up individuals as control group,all patients clinical data analysis group,index and the observation group and control group in corresponding single factor comparison,will be significant difference Logistic regression analysis,to explore the acute descending aorta morbidity factors.Patients in the post-observation group were assigned to group A,and patients in the follow-up examination 2 months later were assigned to group B.Univariate comparative analysis was also performed on the examination results,and Logistic regression analysis was performed on the significantly different items to explore the influencing factors of the disease development of acute descending aorta.Results The single-factor comparison of baseline data between the observation group and the control group showed that the mean arterial pressure,d-dimer and hemomyosin levels in the observation group were significantly higher than those in the control group,with statistically significant difference(P<0.05),while the other two groups had no significant difference(P>0.05).The baseline data of group A and group B showed that the average arterial pressure,d-dimer level,hemomyositis level and prothrombin time in group B were significantly higher than that in group A,and the cardiac ejection fraction was significantly lower than that in group A,with statistically significant differences(P<0.05),and no significant differences in other items(P>0.05).According to the univariate comparison between baseline data of the observation group and the control group,mean arterial pressure,d-dimer and serum creatinine were included as independent variables for Logistic regression analysis.The analysis results showed that:Mean arterial pressure was positively correlated with acute descending aortic dissection(P=0.392,OR=1.480,95%CI=0.505-2.205),serum creatinine was positively correlated with acute descending aortic dissection(P=0.486,OR=1.626,95%CI=1.108-3.091),and d-dimer was not correlated with acute descending aortic dissection(P>0.05).According to univariate comparison of baseline data of group A and group B,mean arterial pressure,d-dimer,serum creatinine and prothrombin time were included as independent variables for Logistic regression analysis.The analysis results showed that:Mean arterial pressure was positively correlated with the development of acute descending aortic dissection(P=0.235,OR=1.265,95%CI=1.017-1.574),serum creatinine was positively correlated with the development of acute descending aortic dissection(P=0.419,OR=1.521,95%CI=1.101-2.101),prothrombin time was positively correlated with the development of acute descending aortic dissection(P=2.523,OR=12.468,95%CI=2.569-60.511).There was no correlation between d-dimer and the development of acute descending aortic dissection(P>0.05).Conclusion Acute descending aorta mezzanine occurrence and development factors is more,high blood pressure in this study showed more obvious positive correlation,and although diabetes related indicators show some correlation,but not sure,studies need to be further developed,make sure to effectively improve the prognosis of patients with the class,improve the diagnostic accuracy rate and risk prediction.