乌鲁木齐市主动脉夹层病例临床特征 变化趋势10年回顾性分析

目的 探讨乌鲁木齐市10年来主动脉夹层病例的临床特征变化趋势.方法 回顾分析新疆维吾尔自治区心血管病研究所暨新疆医科大学第一附属医院1998年1月至2007年12月10年间连续收治并经影像学检查确诊为主动脉夹层的患者,对每年患者的总数、年龄、性别、主动脉夹层类型、治疗方法和疾病预后进行统计和组间比较分析.结果 10年共确诊主动脉夹层238例,发病平均年龄(51.9±12.1)岁,男女之比为3.67:1.175例(73.5%)患者出院诊断合并高血压病,105例(44.1%)患者有明确的大量吸烟史.Ⅰ、Ⅱ、Ⅲ型夹层构成比分别为35.3%、7.6%、57.1%.A型主动脉夹层较B型发病平均年龄低.急性A型主动脉夹层住院病死率为36.5%,急性B型住院病死率为9.5%.在两个5年周期中,主动脉夹层病例增加了240%,其中以Ⅰ型增长最快,为360%.平均发病年龄无显著变化.结论 乌鲁木齐市主动脉夹层住院患者迅速增加,平均发病年龄明显低于国外报道;男性患者比例和急性A型主动脉夹层患者住院病死率均高于国外报道.

Changing trend of clinical characteristics on aortic dissection over the last 10 years in Urumqi

Objective To discuss both clinical and epidemiological features as well as the changing trend of aortic dissection(AD).Methods Retrospective analysis on 238 patients with AD over a 10 year period in the First Affiliated Hospital of Xinjiang Medical University.Hospital records and data on prognosis were compared between the two five-year periods.Results 238 cases with AD were hospitalized during the past 10 years with mesh age as 51.9±12.1.The male/female ratio was 3.67 to 1.Hypertension was present in 73.5%of all the patients.Heavy smoking history was elicited in 44.1% of all the patients.Type Ⅰdissection were identified in 35.3% of all the cases,7.6% in type Ⅱ and 57.1%in type Ⅲ.The mean age of the type A was much younger than in type B.In-hospital mortality of acute type A dissection was 36.5%and acute type B dissection was 9.5%.In the two five-year periods.the total number of cases increased by 240%,among which type Ⅰ the fastest which increased by 360%.Changes regarding mean age and male/female ratio were not obvious.For acute AD,one-year survival rate improved but did not reach statistical significance.Conclusion Our data provided insight into current regional profiles of AD.The number of hospitalized patients with AD was increasing dramatically.Also the mean age of the first-attack was much younger and proportion of males and in-hospital mortality of acute type A dissection were together with both much higher than reports provided by researchers from other regions.These data suggested that there was an urgent need for further improvement in prevention and treatment of AD.