752例主动脉夹层患者的临床特点分析

Analysis of the Clinical Characteristics of 752 Patients with Aortic Dissection

目的分析主动脉夹层(AD)患者的临床特征。方法采用回顾性方法收集752例住院AD患者的一般人口学特征、季节分布和临床分型特点,并总结其合并症、并发症、影像学和实验室检查特点。结果AD患者男女性比例为4∶1,好发于40~60岁人群,平均年龄(52.63±11.47)岁。发病季节以春、秋、冬季为主。疼痛是AD最主要的症状,A型与B型夹层疼痛发生率分别为85.65%和93.98%。肢体麻木、晕厥和休克主要出现在A型患者中,与B型相比差异均有统计学意义(P均<0.05)。A型患者入院时收缩压、舒张压及平均动脉压均低于B型患者(P均<0.001)。心包积液、肺部感染和急性肾衰竭多发生于A型患者(P均<0.05),高血压和马凡氏综合征多见于A型患者(P均<0.05)。结论AD好发于40~60岁的男性,最主要的症状是疼痛,A型患者更危重。

Objective The clinical characteristics of patients with aortic dissection(AD)were analyzed.Methods The seasonal distribution and clinical classification of general demographic characteristics of 752 hospitalized patients with AD were analyzed retrospectively,the coexisting diseases,complications,imaging and laboratory data also be studied.Results The ratio of male to female was 4∶1,the predilection age was between 40-60,the mean of age was(52.63±11.47).AD occurred mainly in Spring,Autumn and Winter.Pain was the most important symptom of AD.The incidence rate of pain in type A and type B patients was 85.65%and 93.98%respectively.The proportion of limb numbness,syncope and shock was significantly higher in type A than in type B patients,the difference was significant(P all<0.05).The baseline systolic blood pressure,diastolic blood pressure and mean artery pressure in type A were lower than those of type B patients(P all<0.001).Compared with type B patients,type A was prone to complicated with pericardial effusion,lung infection,acute kidney dysfunction(P all<0.05),essential hypertension and Marfan′s Syndrome(P all<0.05).Conclusion According to our study,AD usually occurs in men aged 40-60 years,and pain is the main symptom.The most significant character of AD is type A which is more severe and dangerous.