急性主動脈綜合症35例臨床分析

Clinical analysis of 35 cases of acute aortic syndrome

目的分析探討急性主動脈綜合症(Acute aortic syndrome,AAS)臨床表現特點、診斷及治療方案。方法回顧性收集2016年11月~2019年4月收治的35例急性主動脈綜合症患者臨床資料,研究其臨床特點、影像學診斷方法、治療方式及效果。結果AAS患者平均年齡在33歲~91歲之間(中位年齡62.3歲),超過60%患者在51歲~70歲年齡群中。男女比例為4.83:1。主動脈夾層(AAD)有26例(74.3%)、壁内血腫(IMH)有7例(20%)。有高血壓病史(85.7%)。74.3%以突發疼痛為主要表現。D-Dimer診斷敏感性94.7%。92.9%Stanford A型主動脈夾層病例行手術治療。死亡率約20.0%。結論AAS是發病急、病情進展迅速、臨床表現多樣、死亡率極高的心血管疾病。

Objective To investigate the clinical manifestation,diagnosis and treatment of acute aortic syndrome(AAS).Methods According to the clinical data of 35 patients with acute aortic syndrome between November 2016 and April 2019,we analyzed the clinical characteristics,imaging diagnosis,treatment methods and outcomes.Results The average age of AAS patients ranged from 33 to 91 years(median age 62.3 years),more than 60%of patients were in 51-70 age group.The ratio of male to female is 4.83:1.There were 26 cases(74.3%)of aortic dissection(AD)and 7 cases(20%)of intramural hematoma(IMH).85.7%of patients had history of hypertension.74.3%of patients presented with sudden chest pain.The sensitivity of D-Dimer diagnosis was 94.7%.92.9%of Stanfordtype A aortic dissection cases required surgical treatment.There were approximately 20.0%of deaths during hospitalization.Conclusion Acute aortic syndrome is a cardiovascular disease with acute onset,presented a variety of clinical manifestation and high mortality.