Stanford B型主动脉夹层术前发生全身炎症反应综合征的多因素Logistic回归分析

目的 探讨并分析Stanford B型主动脉夹层术前发生全身炎症反应综合征的危险因素.方法 回顾性分析2004年1月-2013年9月151例Stanford B型主动脉夹层患者术前资料,以术前是否发生全身炎症反应综合征为因变量,对术前发生全身炎症反应综合征的影响因素分别进行单因素分析,具有统计学差异的变量继续进行逐步Logistic回归分析.结果 Stanford B型主动脉夹层组术前发生全身炎症反应综合征45例,发病率为29.80％.单因素分析显示,年龄、夹层分期、高血压分级、脏器灌注不良、主动脉瓣关闭不全程度是Stanford B型主动脉夹层术前发生全身炎症反应综合征的危险因素,均P＜0.10.多因素分析显示,主动脉夹层分期(OR:0.927,95％ CI:0.887 ～0.969),年龄(OR:0.171,95％CI:0.070 ～0.417)是Stanford B型主动脉夹层术前发生全身炎症反应综合征的独立危险因素.结论 Stanford B型主动脉夹层术前发生全身炎症反应综合征比例高,主动脉夹层进入慢性期预示Stanford B型主动脉夹层术前发生全身炎症反应综合征减弱或消退.

Logistic regression analysis of risk factors for systemic inflammatory response syndrome with preoperative Stanford type B aortic dissection

Objective To investigate the risk factor for systemic inflammatory response syndrome with preoperative Stanford Type B aortic dissection.Methods From January 2004 to September 2013,clinical data of 151 consecutive patients with Stanford Type B aortic dissection were retrospectively analyzed.Statistically significant risk factors were screened out by univariate analysis,then independent risk factors were identified by stepwise logistic regression analysis.Results Forty-five case of SIRS were induced by preoperative Stanford Type B aortic dissection,incidence of 29.80％.Univarite analysis showed that age,disease stage of aortic dissection,hypertension grading,organ malperfusion,degree of aortic insufficiency were statistically significant risk factors for SIRS with preoperative Stanford Type B aortic dissection,all P ＜ 0.10.Binary logistic regression analysis showed that independent risk factors associated with age,disease stage of aortic dissection,the relative risk and 95 ％ confidencial interval 0.927 (0.887-0.969),0.171 (0.070-0.417) respectively.Conclusions There is a high proportion of SIRS in preoperative Stanford Type B aortic dissection,aortic dissection with chronic phase indicates SIRS reduced or dissipated.