CAJ | 학술논문

目的探讨主动脉夹层(aortic dissection,AD)患者的临床特征及影响预后的若干因素.方法回顾收集2007年1月至2009年12月广州医学院第一附属医院住院确诊为AD病人37例(男31例,女6例),统计分析其的易患因素,A型、B型AD的特点及不同处理方式对预后的影响.结果 AD病人男性占83.7％,高血压占78.4％,大量吸烟占62.2％.AD病人总死亡率为16.2％,A型死亡率为25.0％,B型死亡率5.9％.除A型AD介入治疗死亡率明显增高外；其余内科保守治疗,外科主动脉置换术,B型AD介入治疗三种处理方式比较显示对死亡率影响未见明显区别.结论高血压病、大量吸烟、男性是AD的主要易患因素；AD病死率高,尤以A型为甚；主动脉腔内隔绝术(介人治疗)不宜用于A型AD,是B型AD有效的治疗方法；目前有效的内科治疗仍是AD治疗的基础.
목적 탐토주동맥협층(aortic dissection,AD)환자적림상특정급영향예후적약간인소.방법 회고수집2007년1월지2009년12월엄주의학원제일부속의원주원학진위AD병인37례(남31례,녀6례),통계분석기적역환인소,A형、B형AD적특점급불동처리방식대예후적영향.결과 AD병인남성점83.7％,고혈압점78.4％,대량흡연점62.2％.AD병인총사망솔위16.2％,A형사망솔위25.0％,B형사망솔5.9％.제A형AD개입치료사망솔명현증고외；기여내과보수치료,외과주동맥치환술,B형AD개입치료삼충처리방식비교현시대사망솔영향미견명현구별.결론 고혈압병、대량흡연、남성시AD적주요역환인소；AD병사솔고,우이A형위심；주동맥강내격절술(개인치료)불의용우A형AD,시B형AD유효적치료방법；목전유효적내과치료잉시AD치료적기출.
Objective To explore the clinical featuers in patients with aortic dissection (AD) and the factors affecting the prognosis of the disease.Methods The data on 37 patients (31 males and 6 females)with AD who had been hospitalized from January 2007 to December 2009 were retrospectively collected.The risk factors,characteristics of types A and B,and effects of different therapies on the prognosis were analyzed.Results Of the patients with AD,83.7％ were male,78.4％ had hypertension,and 62.2％ were heavy smokers.The total mortality rate was 16.2％; and the mortality rate was 25％ for type A and 5.9％ for type B.The mortality rate significantly increased in type A patients undergoing endovascular repair procedure and it did not differ significantly among the patients receiving medical therapyor surgical aortic replacement,or those with type B undgoing endovascular repair procedure.Conclusions Hypertension,heavy smoking,and male are the main risk factors for AD.AD has a higher mortality rate,especially for type A.Endovascular exclusion (endovascular repair procedure) is not recommended as a treatment for type A; however,it is an effective procedure for type B.Medical therapy is still the fundamental treatment for both types of AD.