Sex-Related Differences Between Patients With Symptomatic Acute Aortic Dissection.
Sex-Related Differences Between Patients With Symptomatic Acute Aortic Dissection.
复制标题
DOI：
10.1097/md.0000000000003100
复制
发表时间：
2016-03
期刊：
影响因子：
1.6
通讯作者：
Ma YT
中科院分区：
文献类型：
--
作者：
Maitusong B;Sun HP;Xielifu D;Mahemuti M;Ma X;Liu F;Xie X;Azhati A;Zhou XR;Ma YT
我们设计了一项回顾性队列研究，以评估症状性急性主动脉夹层（AAD）患者在临床表现、发病率和结局方面的性别差异。我们收集了2010年至2015年400例AAD患者的临床数据。患者的临床特征、治疗和结果作为性别的函数进行分析。400例AAD患者中，男女比例为3.18：1，女性动脉粥样硬化发生率较高（P = 0.02）。 男性中，视力障碍（P = 0.01）、局灶性神经功能缺损（P = 0.04）和脉搏缺损（P =0.03）更常见。 影像学检查显示男性患者胸腔积液（P <0.01）、腹腔干受累（P <0.01）和肠系膜上上级动脉受累（P = 0.02）更常见。 夹层相关性肺炎（P = 0.02）、肺不张（P = 0.01）、主动脉壁内血肿（P <0.01）、缺血性心电图改变（P = 0.03）和院内并发症如心肌缺血（P = 0.03）、低氧血症（P <0.01）、心包填塞（P = 0.01）在女性患者中发生率较高。 女性A型夹层患者的住院病死率高于男性（P <0.01）。 AAD的表现因患者的性别而异。女性AAD的临床特征与男性不同，主要表现为发病年龄大、住院并发症多、住院死亡率高。这些发现可能有助于更好地了解女性主动脉夹层，从而改善其预后。
We designed a retrospective cohort study to assess sex-related differences in clinical manifestations, incidence, and outcomes of patients with symptomatic acute aortic dissection (AAD). We collected clinical data from 2010 to 2015 of 400 patients with AAD. Patients’ clinical characteristics, treatment, and outcomes were analyzed as a function of sex. Among 400 patients with AAD, the ratio of men to women was 3.18:1; the incidence of atherosclerosis was higher in women (P = 0.02). Dysphoria (P = 0.01), focal neurological deficits (P = 0.04), and pulse deficits (P = 0.03) were more frequent in men. Imaging findings revealed that pleural effusion (P < 0.01), celiac trunk involvement (P < 0.01), and superior mesenteric artery involvement (P = 0.02) were more frequent in men. Dissection-related pneumonia (P = 0.02), pulmonary atelectasis (P = 0.01), aortic intramural hematoma (P < 0.01), ischemic electrocardiographic changes (P = 0.03), and in-hospital complications such as myocardial ischemia (P = 0.03), hypoxemia (P < 0.01), cardiac tamponade (P = 0.01) occurred more frequently in women. Women with type A dissection had higher in-hospital mortality than men (P < 0.01). The presentation of AAD varies with a patient's sex. Women with AAD had clinical features different from men as follows: higher age of onset, more frequent inpatient complications, and higher in-hospital mortality. These findings may lead to a better understanding of aortic dissection in women that will improve their outcomes.