CAJ | 학술논문

目的分析河南省10年来主动脉夹层病例的临床特征变化趋势.方法回顾2003年1月至2012年12月河南省人民医院、郑州大学第一附属医院和河南省胸科医院心外科连续收治并经影像学检查确诊为主动脉夹层的患者,统计每年患者的总数、年龄、性别、主动脉夹层类型、治疗方法和疾病预后,进行分析.结果 3家单位10年共确诊主动脉夹层906例,发病平均年龄(50.2±9.8)岁,男女之比为3.49∶1.546例(60.3％)患者出院诊断合并高血压病,292例(32.2％)有明确的大量吸烟史.其中Stanford A型夹层524例,B型382例,A型、B型夹层构成比分别为57.8％、42.2％.河南省急性A型主动脉夹层的住院病死率21.8％,急性B型主动脉夹层住院病死率6.8％.在两个5年周期中,主动脉夹层病例增加了216％.Stanford A型夹层增长最快,为294％.平均发病年龄无显著变化.结论 10年间河南省主动脉夹层的住院患者迅速增多,男性发病率高,平均发病年龄明显低,与高血压病和大量吸烟史关系密切.急性主动脉夹层A型住院病死率高.
목적 분석하남성10년래주동맥협층병례적림상특정변화추세.방법 회고2003년1월지2012년12월하남성인민의원、정주대학제일부속의원화하남성흉과의원심외과련속수치병경영상학검사학진위주동맥협층적환자,통계매년환자적총수、년령、성별、주동맥협층류형、치료방법화질병예후,진행분석.결과 3가단위10년공학진주동맥협층906례,발병평균년령(50.2±9.8)세,남녀지비위3.49∶1.546례(60.3％)환자출원진단합병고혈압병,292례(32.2％)유명학적대량흡연사.기중Stanford A형협층524례,B형382례,A형、B형협층구성비분별위57.8％、42.2％.하남성급성A형주동맥협층적주원병사솔21.8％,급성B형주동맥협층주원병사솔6.8％.재량개5년주기중,주동맥협층병례증가료216％.Stanford A형협층증장최쾌,위294％.평균발병년령무현저변화.결론 10년간하남성주동맥협층적주원환자신속증다,남성발병솔고,평균발병년령명현저,여고혈압병화대량흡연사관계밀절.급성주동맥협층A형주원병사솔고.
Objective To discuss the clinical epidemiology features and change trend of aortic dissection (AD) in Henan Province.Methods Retrospective analysis of consecutive 906 patients with AD over 10 years in Henan Provincial People' s Hospital,the First Affiliated Hospital of Zhengzhou University and Henan Provincial Chest Hospital.Hospital records and prognosis were compared between two five-year periods.Results 906 cases with AD were hospitalized during the past 10years.The mean age was (50.2 ± 9.8) years.The male/female ratio was 3.49 ∶ 1.Hypertension was present in 60.3 ％ of all patients.Heavy smoking history was elicited in 32.2％ of all patients.Type A dissection were identified in 57.8％ of all the cases,and type B in 42.2％.In-hospital mortality of acute type A dissection was 21.8％,acute type B dissection 6.8％.In two five-year periods,the total number of cases increased by 216％,among which type A was the fastest,increased by 294％,Changes of mean age and male/female ratio were not significant.For acute AD,changes of prognosis in one year improved,and reach statistical significance (P ＜ 0.05).Conclusion This study provides insight into current regional profiles of AD.The number of hospitalized patients with AD is increasing dramatically.The mean age of the first-attack is much younger and the male ration is much higher than that reported by other regional researchers.These data support the urgent need for further improvement in prevention and treatment of AD.