Stanford B型主动脉夹层临床资料分析

目的 分析Stanford B型主动脉夹层患者的临床特征。方法 连续入选2012年4月至2013年1月就诊于阜外医院并经计算机断层血管造影（CTA）确诊为Stanford B型主动脉夹层的患者,收集患者入院时临床资料及治疗情况,并分析有无高血压病史以及是否接受手术治疗患者的临床特征的差异。结果 入选74例Stanford B型主动脉夹层,平均年龄52.47岁,男性65例（87.8%）。合并高血压病史53例（71.6%）,与无高血压病史的患者比较,其平均年龄、性别比例、体重指数、个人史、入院重要生命体征、临床表现、主要实验室检查及药物、手术治疗情况均无显著差异（p值均〉0.05）。入院后接受腔内修复手术治疗的患者45例（60.8%）,入院时白细胞计数（13.1±4.6 vs.10.7±4.3×10^9/L,p=0.035）显著高于未接受腔内隔绝术患者,其他临床资料两组间无显著差异（p值均〉0.05）。结论 高血压仍是Stanford B型主动脉夹层患者最常见的合并症,但主动脉夹层发病后呈现的临床特征与无高血压病史者无显著差异。腔内隔绝术已成为Stanford B型主动脉夹层较常见的治疗方法。

Clinical Characteristics of Stanford B Aortic Dissection

Objective To analyze the clinical characteristics in patients with Stanford B type aortic dissection. Methods A series of consecutive patients who were diagnosed with Stanford B type aortic dissection by computed tomography angiography （CTA） were enrolled from Fuwai hospital between April 2012 and January 2013. The clinical characteristics were analyzed according to hypertension history and interventional therapy. Results The present study included in a total of 74 patients with Stanford B type aortic dissection with a mean age of 52.47 years （male, 87.8%）. Fifty-three patients （71.6%） had a history of hypertension and the age, gender, BMI, medical history, vital signs of admission, clinical presentation, and main lab examinations were comparable between patients with and without hypertension （all P〉0.05）. Forty-five patients （60.8%） received treatment of endovascular graft exclusion. The admission white blood cells in patients received interventional therapy were significantly higher than that in those with medical conservative therapy （13.1±4.6 vs.10.7±4.3 × 10^9/L, P=0.035）. Conclusion Hypertension is the most common co-morbidity in patients with Stanford type B aortic dissection; and no differences were found in clinical characteristics between patients with and without hypertension. Endovascular graft exclusion is the common treatments for Stanford type B aortic dissection.