Are dilated ascending aortas of Chinese patients more likely to dissect?
Are dilated ascending aortas of Chinese patients more likely to dissect?
复制标题
中国患者升主动脉扩张是否更容易发生夹层？
DOI：
10.21037/cdt-20-313
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发表时间：
2020-07
影响因子：
2.4
通讯作者：
Zhang Hongjia
中科院分区：
文献类型：
--
作者：
Jiang Wenjian;Liu Jihong;Dai Lu;Liu Yang;Wu Zining;Zhang Hongjia
背景
升主动脉瘤是一种需要手术治疗的疾病。然而，手术的时间仍然存在争议。本研究的目的是比较中国医院单纯升主动脉夹层与单纯升主动脉扩张术患者的升主动脉内径及术后住院时间，探讨单纯根据升主动脉内径确定手术时机的准确性。
方法
我们回顾了2010年1月至2017年6月在本院接受手术治疗的2520例主动脉瘤和主动脉夹层的住院患者的资料。入选139例单纯性升主动脉夹层和单纯性升主动脉瘤住院患者，不包括马凡综合征和心脏瓣膜疾病等，其中主动脉扩张组56例，主动脉夹层组83例。两组间差异比较采用t检验和单变量分析。
结果
在升主动脉直径方面，动脉瘤组升主动脉内径和升主动脉直径指数均大于夹层组(P<；0.001，P<；0.001)。对于男性患者，结果是相同的(P<；0.001，P<；0.001)。但对于女性患者，两组间差异无统计学意义(P=0.631，P=0.288)。在术后转归方面，夹层组病死率、气管切开发生率、术后再探查出血发生率均高于夹层组(P=0.040，P=0.011，P=0.028)。
结论
大多数单纯性升主动脉夹层患者的主动脉直径为5.5厘米，这与目前主动脉瘤的手术指征不一致。仅凭主动脉直径来预测主动脉夹层是远远不够的。要做到这一点，需要更多的指标。
Background
Ascending aortic aneurysm is a disease requiring surgical intervention. However, the timing of operation is still controversial. The purpose of this study is to compare the ascending aortic diameter and postoperative outcomes in hospital between patients with simple ascending aortic dissection and patients with simple ascending aortic dilation in China, and to investigate the accuracy of the timing of operation determined by ascending aortic diameter alone.
Methods
We reviewed the data from 2,520 hospitalized patients of aortic aneurysm and aortic dissection who underwent surgical treatment from January 2010 to June 2017 in our hospital. A total of 139 simple ascending aortic dissection and simple ascending aortic aneurysm hospitalized patients excluding Marfan syndrome and heart valve diseases etc. (56 in the aortic dilatation group and 83 in the aortic dissection group) were enrolled. The t-test and univariable analysis were used to compare the differences between two groups.
Results
For the aortic diameter, the group of aneurysm has greater ascending aortic diameter and the index of ascending aortic diameter compared with the group of dissection (P<0.001, P<0.001). For male patients, the result is the same (P<0.001, P<0.001). But for female patients, there was no significant statistical significance between the two groups (P=0.631, P=0.288). For the postoperative outcomes, the dissection group had higher mortality, incidence of tracheotomy and postoperative re-exploration for hemorrhage (P=0.040, P=0.011, P=0.028).
Conclusions
The majority of patients with simple ascending aortic dissection present with aortic diameters <5.5 cm and this is not consistent with the current operation indications of aortic aneurysm. It is far from enough to predict aortic dissection with aortic diameter alone. More indicators are needed to do this.
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影响因子：
37.8
作者：
C. Olsson;S. Thelin;E. Ståhle;A. Ekbom;F. Granath
通讯作者：
C. Olsson;S. Thelin;E. Ståhle;A. Ekbom;F. Granath
DOI：
10.1016/j.jtcvs.2004.07.009
发表时间：
2004-11-01
影响因子：
6
作者：
Borger, MA;Preston, M;David, TE
通讯作者：
David, TE
影响因子：
158.5
作者：
Gott, VL;Greene, PS;Pyeritz, RE
通讯作者：
Pyeritz, RE
影响因子：
9.6
作者：
Mészáros, I;Mórocz, J;Szép, L
通讯作者：
Szép, L
影响因子：
6.2
作者：
J. Jue;M. Boodhwani;L. Beauchesne;C. Dennie;K. Chan;T. Coutinho
通讯作者：
J. Jue;M. Boodhwani;L. Beauchesne;C. Dennie;K. Chan;T. Coutinho