主动脉夹层发病的影响因素分析

Analysis of Influencing Factors in the Pathogenesis of Aortic Dissection

目的:研究不同因素对主动脉夹层(aortic dissection, AD)的影响,丰富健全AD的发病风险分层评估,为AD的预防及发病机制的研究提供新的思考。方法:病例对照研究,收集2019年4月至2022年10月在海南医学院第二附属医院就诊AD患者222例为实验组;收集对照组患者200例。对影响AD发生的因素采用logistics回归分析。结果:多因素logistics回归分型显示,男性(OR = 2.937, 95% CI 1.671~5.163, p < 0.05)、BMI (OR = 1.221, 95% CI 1.140~1.308, p < 0.05)、吸烟史(OR = 1.766, 95% CI 1.030~3.028, p = 0.039)、高血压(OR = 4.434, 5% CI 2.652~7.414, p < 0.05)与AD发病显著相关;男性OR = 4.075 (95% CI 2.086~7.962, p < 0.05)、BMI OR = 1.309 (95% CI 1.206~1.421, p < 0.001)、高血压OR = 2.753 (95% CI 1.511~5.016, p < 0.05)、TG OR = 0.331 (95% CI 0.194~0.564, p < 0.05)与A型主动脉夹层(Type A aortic dissection, TAAD)发病显著相关;吸烟(OR = 2.476, 95% CI 1.102~5.564, p < 0.05)、高血压(OR = 16.55, 95% CI 5.136~53.13, p < 0.05)、甘油三脂(Triglyceride, TG) (OR = 1.494, 95% CI 1.124~1.986, p < 0.05)与B型主动脉夹层(Type B aortic dissection, TBAD)发病显著相关。结论:男性、BMI、吸烟、TG等因素对AD的分型TAAD、TBAD的发病影响不同,可能与不同来源的血管平滑肌(vascular smooth muscle cells, vSMC)有关。

Objective: To study the influence of different factors on aortic dissection (AD), enrich and improve the risk stratification assessment, and provide new thinking for the prevention and pathogenesis. Methods: In a case-control study, 222 AD patients in the Second Affiliated Hospital of Hainan Medi-cal University from April 2019 to October 2022 were collected as the experimental group. 200 pa-tients in the control group were collected. The factors affecting the occurrence of AD are analyzed by logistics regression. Results: Multi-factor logistics regression typing shows, Male (OR = 2.937, 95% CI 1.671~5.163, p < 0.05), BMI (OR = 1.221, 95% CI 1.140~1.308, p < 0.05), smoking history (OR = 1.766, 95% CI 1.030~3.028, p = 0.039), hypertension (OR = 4.434, 95% CI 2.652~7.414, p < 0.05) were significantly correlated with the incidence of AD. Male OR = 4.075 (95% CI 2.086~7.962, p < 0.05), BMI OR = 1.309 (95% CI 1.206~1.421, p< 0.001), hypertension OR = 2.753 (95% CI 1.511~5.016, p < 0.05), TG OR = 0.331 (95% CI 0.194~0.564, p < 0.05) were significantly correlated with Type A aortic dissection (TAAD). Smoking (OR = 2.476, 95% CI 1.102~5.564, p < 0.05), hyper-tension (OR = 16.55, 95% CI 5.136~53.13, p < 0.05), Triglyceride (TG) (OR = 1.494, 95% CI 1.124~1.986, p < 0.05) was significantly associated with Type B aortic dissection (TBAD). Conclu-sions: Male, BMI, smoking, TG and other factors have different effects on the incidence of AD classi-fication TAAD and TBAD, which may be related to different sources of vSMC.