PROGNOSIS OF ABDOMINAL AORTIC-ANEURYSMS - A POPULATION-BASED STUDY
PROGNOSIS OF ABDOMINAL AORTIC-ANEURYSMS - A POPULATION-BASED STUDY
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DOI：
10.1056/nejm198910123211504
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发表时间：
1989-10-12
影响因子：
158.5
通讯作者：
HALLETT, JW
中科院分区：
文献类型：
--
作者：
NEVITT, MP;BALLARD, DJ;HALLETT, JW
关于异常主动脉瘤的扩张率和破裂风险与其大小相关的信息是不完整的。为了解决这些问题，我们总结了一项基于人群的研究。在明尼苏达州罗切斯特市的370名居民中，有181人在1951年至1984年期间首次被诊断为动脉瘤，其中181人通过超声波检查记录了动脉瘤。在103名接受了一次以上超声研究的患者中，动脉瘤直径平均每年增加0.21厘米。只有24%的人每年扩张0.4厘米或更多。在最初超声研究时有未破裂动脉瘤的176名患者中，5年后破裂的累积发生率为6%，10年后为8%。然而，直径小于5厘米的130名患者五年内破裂的风险为0%，直径大于或等于5厘米的46名患者的破裂风险为25%。所有16例破裂的患者在破裂时都有直径大于或等于5厘米的动脉瘤。这些基于人群的数据挑战了临床上认为动脉瘤通常以每年0.4至0.5厘米的速度扩张的看法。我们的数据还表明，对于直径小于5厘米的动脉瘤，破裂的风险比以前报道的要低得多。然而，对于直径5厘米或更大的动脉瘤，破裂的风险是相当大的。
Information is incomplete about the rate of expansion of abnormal aortic aneurysms and the risk of rupture in relation to their size. To address these questions, we conclude a population-based study. Of the 370 residents of Rochester, Minn., with an aneurysm initially diagnosed from 1951 through 1984, 181 had the aneurysm documented by ultrasound examination. Among the 103 patients who underwent more than one ultrasound study, the diameter of the aneurysm increased by a median of 0.21 cm per year. Only 24 percent had a rate of expansion of 0.4 cm or more per year. Among the 176 patients who had an unruptured aneurysm at the time of the initial ultrasound study, the cumulative incidence of rupture was 6 percent after 5 years and 8 percent after 10 years. However, the risk of rupture over five years was 0 percent for the 130 patients with an aneurysm less than 5 cm in diameter and 25 percent for the 46 patients with an aneurysm 5 cm or more in diameter. All of 16 patients who had ruptures had aneurysms that were 5 cm or more in diameter at the time of the rupture. These population-based data challenge the clinical perception that aneurysms typically expand at a rate of 0.4 to 0.5 cm per year. Our data also suggest that for aneurysms less than 5 cm in diameter the risk of rupture is considerably lower than has been reported previously. However, the risk of rupture is substantial for aneurysms 5 cm or more in diameter.