老年StandfordB型主动脉夹层患者冠状动脉造影的临床意义

目的探讨老年StandfordB型主动脉夹层患者中冠状动脉粥样硬化性心脏病（冠心病）的检出率及其相关危险因素。方法回顾性分析134例50岁以上同时进行主动脉造影和冠状动脉造影的StandfordB型主动脉夹层患者的临床资料及影像学资料．对数据进行统计分析。结果134例患者中，冠心病的检出率为26．1％（35例），其中单支病变22例（16．4％），2支病变9例（6．7％），左主干或3支病变4例（3．0％）。多因素Logistic回归分析显示．男性（OR=6．682，95％CI1．01—44．13，P=0．049）及吸烟（OR=3．513，95％CI1．05-11．70，P=0．041）是StandfordB型主动脉夹层合并冠心病的预测因素。结论50岁以上StandfordB型主动脉夹层患者共患冠心病的比例较高，在主动脉造影时有必要常规进行冠状动脉造影检查，以免漏诊。

Clinical significance of coronary angiography in elderly patients with Stanford type B aortic dissection

Objectives To explore the prevalence of coronary artery disease(CAD) and its predictors in elderly patients with Stanford type B aortic dissection.Methods Clinical and image data of 134 patients who were more than 50 years old with Stanford type B aortic dissection and underwent coronary angiography immediately after aortography were retrospectively analyzed.The data were treated by statistical analysis.Results Of the 134 patients,coronary angiography showed 35 patients(26.1%) had CAD: 22(16.4%) with single-vessel disease,9(6.7%) with multiple-vessel disease,4(3.0%) with triple-vessel disease or left main coronary disease.Multivariate Logistic analysis showed that male(OR=6.682,95% CI 1.01-44.13,P=0.049) and smoking(OR=3.513,95% CI 1.05-11.70,P=0.041) were predictors of Stanford type B aortic dissection with CAD.Conclusions Incidence of CAD in patients aged over 50 with Stanford type B aortic dissection is relatively high.Routine coronary angiography should be performed at the same time with aortography in order to screen this specific high risk population.