腹主动脉瘤附壁血栓分布规律和相关因素分析

目的:研究腹主动脉瘤(AAA)附壁血栓(ILT)的生长规律，探讨ILT与年龄、性别、AAA直径的关系。方法:对103例AAA连续病例行CT扫描，观察有无ILT及ILT的分布规律，测量AAA直径和ILT最大厚度，分析ILT与年龄、性别及动脉瘤大小的关系。结果:66．9％AAA有ILT，女性AAA有ILT较少见(15．4%)。ILT与AAA直径、患者年龄相关，AAA直径小于40mm时形成ILT的比例为21．4％，年龄小于60岁时形成ILT的比例为25．0％。以近端瘤颈截面的中心和髂动脉分叉做一连线，血栓总是分布在距离该轴线较远的瘤壁。结论瘤体内血流可能是ILT形成的重要因素；女性和年龄小于60岁不易形成血栓，提示ILT的形成是多因素的。

Intraluminal thrombus in abdominal aortic aneurysms:distribution and influential factors in its formation

Objective To investigated the distribution of intraluminal thrombus (ILT) in abdominal aortic aneurysms (AAAs), and to examine the influence of age, gender and aneurysm diameters on the ILT formation. Methods Morphological analysis of ILT in AAA of 103 consecutive patients was undertaken with helical CT angiography. ILT shape, distribution and thickness of ILT were recorded and analyzed in correlation with age, gender and aneurysm diameters. Results ILT were found in 66.9% of all the patients. ILT was always situated in the area away from the main axis of AAA. The incidence of ILT in female group (n=13) was much lower than that in male group (n=90) (15.5% vs 77.4%, P<0.01). Patients who were younger than 60 years (n=12) had lower frequency of ILT formation (25.0%). AAA with diameter less than 40mm (n=14) also had a lower incidence of ILT (21.4%), while no statistical differences were found in those with AAA diameters over 40mm. The thickness of ILT increased with increase in AAA diameter. Conclusion The location of ILT might be mainly determined by blood flow. The relatively lower incidence of ILT in female and young patients indicated the multifactorial pathogenesis of ILT.