主动脉夹层诊断的相关临床特征分析

目的探讨有助于主动脉夹层（ AD）诊断的相关临床特征，提高AD的诊治率。方法回顾性分析2010年3月~2012年10月本院收治的510例因胸背疼痛而行胸腹主动CT血管成像确诊或排除AD患者的病历资料、实验室检查及影像学检查结果，对病情变化中有助诊断AD的可能相关因素进行多因素非条件logistic回归分析。结果确诊AD患者137例，排除AD患者373例，多因素非条件logistic回归分析提示，胸背放射疼痛、高血压、胸腔积液、血D-二聚体升高4个指标进入了AD诊断参数模型（ P〈0.05或P〈0.01）。结论入院胸背放射疼痛、血压高、胸腔积液、血D-二聚体升高是AD诊断的高度密切相关因素。

Analysis of related clinical features in the diagnosis of aortic dissection

Objective To analyze the related clinical features which are helpful to the diagnosis of aortic dissection（AD）in order to improve the diagnosis and treatment rate of AD. Methods Total 510 patients who suffered from chest and back pain and received chest and abdomen active CT angiography for diagnosis or exclusion of AD in our hospital from Mar. of 2010 to Oct. of 2012 were selected,and multi-factor non-conditional logistic regression analysis was made on the basis of their medical records,laboratory examination,imaging examination,and possible factors related to the change of illness conditions. Results Total 137 patients were diagnosed with AD and 373 patients were diagnosed without AD. The multi-factor non-conditional logistic regression analysis showed that the four factors,i. e. ,radiation pain,hypertension,pleural effusion,and blood D-dimer increase entered the AD diagnosis parameter model（P 〈0. 05 or P 〈0. 01）. Conclusion In-hospital radiation pain,hypertension,pleural effusion,blood D-dimer increase are factors closely related to AD diagnosis.