急性主动脉综合征患者的临床特点分析——一项单中心回顾性研究

Analysis of the clinical characteristics of patients with acute aortic syndrome:a single-center retrospective study

目的分析急性主动脉综合征(AAS)患者的临床特点,旨在为AAS的防治提供依据。方法收集2016年9月至2020年8月开封市中心医院出院病历中首次诊断为AAS患者的临床资料。对患者的基线资料、致病风险因素、年龄、发病时间段、发病特点、临床转归情况进行统计分析,并对患者入院时的收缩压(SBP)、心率、D-二聚体、白细胞计数(WBC)、C-反应蛋白(CRP)相关指标进行多重线性回归分析。结果4年来,本院共收治首次确诊AAS的患者116例,其中男性90例,女性26例,男:女为3.462:1;平均年龄(59.59±15.26)岁,61~70岁年龄段患者所占比例最多〔27.59%(32/116)〕;平均住院时间(17.83±12.34)d。AAS患者的主要病因为高血压〔78.45%(91/116)〕和动脉粥样硬化〔42.24%(49/116)〕。在12月份AAS发病率最高〔13.79%(16/116)〕,其次为2月份和7月份;发病时间集中在06:00—12:00〔32.76%(38/116)〕,其次为18:00—24:00。发病时以胸、腹和(或)背部疼痛者居多〔27.59%(32/116)〕,其次为胸闷、胸痛或胸骨后闷压感以及撕裂样疼痛。多重线性回归分析显示,入院时SBP对患者是否存活具有预测价值(B值=0.003,sx=0.001,β值=0.371,P=0.000)。结论AAS是低发病率、高病死率的疾病,发病呈年轻化趋势,男性患病率较女性明显偏高,其主要病因是高血压和动脉粥样硬化,寒冷季节和季节交替可能是发病的气候因素,在06:00—12:00时间段发病率最高。入院时SBP对患者是否存活具有预测价值。

Objective The clinical characteristics of patients with the acute aortic syndrome(AAS)are analyzed to provide a basis for the management of AAS.Methods Clinical data of patients with the first diagnosis of AAS in the discharge records of Kaifeng Central Hospital from September 2016 to August 2020 were collected.Baseline data,causative risk factors,age,period of onset,characteristics of onset,and clinical regression were statistically analyzed,and multiple linear regression analysis was performed on systolic blood pressure(SBP),heart rate,D-dimer,white blood cell count(WBC),and C-reactive protein(CRP)at the time of patient admission.Results Over the past 4 years,116 patients were admitted to our hospital with the first diagnosis of AAS,90 of whom were male and 26 female,with a male:female ratio of 3.462:1;the average age was(59.59±15.26)years,with the largest proportion of patients in the 61-70 age group[27.59%(32/116)];the average length of stay was(17.83±12.34)d.The main causes of AAS patients were hypertension[78.45%(91/116)],and atherosclerosis[42.24%(49/116)].The incidence of AAS was highest in December[13.79%(16/116)],followed by February and July.The onset of the disease was concentrated between 06:00 and 12:00[32.76%(38/116)],followed by 18:00-24:00.Chest,abdominal,and/or back pain was predominant[27.59%(32/116)],followed by chest tightness,chest pain,poststernal tightness and tearing pain.Multiple linear regression analysis showed that SBP on admission was predictive of survival(B value=0.003,sx=0.001,βvalue=0.371,P=0.000).Conclusions AAS is low morbidity and high mortality disease with young onset and a significantly higher prevalence in men than in women.Its main causes are hypertension and atherosclerosis,with cold seasons and seasonal changes as climatic factors,and the highest incidence period is between 06:00 and 12:00.SBP on admission has a predictive value for patient survival.