单中心近10年腹主动脉瘤1246例流行病学研究

Epidemiological study of 1246 cases of abdominal aortic aneurysm from a single center in the last 10 years

目的回顾性分析近10年中国医科大学附属第一医院收治的腹主动脉瘤(AAA)病人的流行病学特点,为研究近10年AAA流行病学变化趋势,以及为AAA的进一步预防和诊治提供依据。方法纳入自2011年1月至2020年12月中国医科大学附属第一医院诊治的1246例AAA病人的病案资料,回顾性分析包括病人年龄、性别、就诊时间、就诊科室、首发症状、住院时间、住院费用、术式选择等信息,分析近10年AAA流行病学变化特点。结果入院病人平均年龄为(66.9±10.5)岁,男女占比约为4∶1。男性AAA病人以同型半胱氨酸升高为主,女性以血脂升高为主。AAA病人的主要合并症为3级高血压(41.9%)、冠心病(31.1%)和合并髂动脉瘤(25.8%)。男性AAA合并髂动脉瘤比率明显高于女性(27.8%vs.17.8%,P<0.01)。72.7%的AAA病人首诊原因为体检发现,其次是AAA破裂(18.7%)。AAA病人急诊与门诊就诊例数呈逐年升高态势,急诊与门诊就诊占比约为2∶3。65~69岁为现阶段住院病人主要年龄段。各年份男性占比约为80%,年龄段65~69岁为男性占比可达近90%。各年份腔内修复术(EVAR)是AAA的主要治疗方式,行EVAR治疗病人的例数和比例总体趋势逐年增加,行EVAR治疗的占比随病人年龄增加而逐渐增大。近10年AAA病人的病死率呈降低趋势,2015年后病死率总体维持在2%~3%,以男性为主,年龄段70~74岁的病死率最高为5.8%。AAA病人平均住院(17.0±16.4)d,平均住院费用为(11.3±10.7)万元。结论近10年AAA住院病人有逐年增高趋势,主要患病人群为年龄>60岁男性,男女临床特点有较大差异。采用EVAR治疗的占比逐年增加。对于老年AAA人群,尤其是年龄段65~69岁男性AAA病人,在AAA的防治过程中应给予更多关注。

Objective Retrospective analysis of the epidemiological characteristics of patients with abdominal aortic aneurysm(AAA)in the First Affiliated Hospital of China Medical University in recent 10 years,in order to better analyze the epidemiological trends of AAA and provide evidence for the prevention,diagnosis and treatment of AAA.Methods A total of 1246 patients with AAA were included in this study from January 2011 to December 2020.Analyses included the patients’age,gender,date of treatment,department of treatment,first symptom,length of stay,hospitalization expenses,choice of operation and other informations.Results The mean age of the patients was(66.9±10.5)years,the male-to-female ratio was about 4:1.Male AAA patients are mainly characterized by elevated homocysteine,while female patients are mainly characterized by elevated blood lipid.The main complications included grade 3 hypertension(41.9%),coronary artery disease(31.1%)and with iliac artery aneurysm(25.8%).The proportion of male patients with AAA was significantly higher than female patients(27.79%vs 17.77%,P<0.01).The most AAA patients was first diagnosed by physical examination(72.7%),the second reason was the ruptured AAA(18.7%).The number of emergency and outpatient visits of AAA patients displayed an increasing trend each year.The proportion of emergency and outpatient visits was about 2:3.65-69 was the main age group of hospitalized patients at current stage.The proportion of males in each year is about80%,and the proportion of males aged 65-69 can reach nearly 90%.EVAR(Endovascular aneurysm repair)is the main treatment for AAA and the number and proportion of patients treated with EVAR increased each year.The proportion of patients treated with EVAR increased with age.In recent 10 years,the in-hospital mortality rate of AAA patients showed a decreasing trend.After 2015,the overall mortality rate remained about 2%-3%and were predominantly male.The age group of 70-74 years showed the highest in-hospital mortality rate.The average length of stay of AAA patients was(17.0±16.4)days.The average total hospital charges was(11.3±10.7)ten-thousand yuan.Conclusion In recent 10 years,the number of hospitalized patients with AAA has increased each year.The vulnerable populations are men over 60 years old.There are great differences in clinical characteristics between men and women.The in-hospital mortality rate of AAA patients displayed a decreasing trend each year.More attention should be paid to the elderly people with AAA,especially the male patients aged 65-69.