他汀抑制急性B型主动脉夹层患者介入术后腹主动脉段的扩张趋势

Statin attenuates the expansion trend of abdominal aorta after thoracic endovascular aortic repair in patients with acute Stanford type-B aortic dissection

目的:探讨对急性Stanford B型主动脉夹层患者行胸主动脉腔内修复术(TEVAR)后应用他汀是否对腹主动脉段扩张的趋势具有抑制作用。方法:纳入2018年1月-2019年5月武汉亚洲心脏病医院急性B型主动脉夹层行TEVAR术患者120例,术后随机分为他汀组与对照组(各60例)。术前与术后1年均行CT检查。结果:术前2组在基线资料方面具有可比性(P均>0.05),在手术方式、支架平均直径及平均长度方面比较,差异无统计学意义(P均>0.05)。1年后CT随访结果显示,2组术后胸主动脉段重塑良好,胸主动脉段假腔血栓化比例均达到100%。在腹主动脉段,他汀组术后腹主动脉最大直径略小于对照组,但差异无统计学意义(P>0.05);他汀组术后1年腹主动脉最大直径的增长值明显小于对照组(P<0.05)。结论:对于急性B型主动脉夹层行TEVAR术成功的患者,术后应用他汀有助于减缓腹主动脉段扩张趋势。

Objective:To explore whether statin attenuates the expansion trend of abdominal aorta after thoracic endovascular aortic repair(TEVAR)in patients with acute Stanford type-B aortic dissection.Methods:From January 2018 to May 2019 in Wuhan Asia Heart Hospital,120 patients with acute Stanford type-B aortic dissection were randomly divided into the statin group and control group after TEVAR procedure(both n=60).CT scans were performed before TEVAR and 1 year after the procedure.Results:The baseline data of the two groups were comparable before TEVAR(all P>0.05).There was no statistically significant difference between the two groups in TEVAR approach,mean diameter and length of aortic covered stent(all P>0.05).One-year CT follow-up showed that the thoracic aortic segment remodeling was good in the two groups.Both the proportion of false lumen thrombosis of thoracic aorta was 100%.In the segment of abdominal aorta,the maximum diameter in the statin group was slightly smaller than that in the control group,but the difference was not statistically significant(P>0.05).The increase of the maximum diameter of abdominal aorta in the statin group was significantly less than that in the control group(P<0.05).Conclusion:After successful TEVAR in patients with acute type-B aortic dissection,statin could be useful to slow down the trend of abdominal aortic segment expansion.