Thoracic aortic aneurysms: a population-based study.

Thoracic aortic aneurysms: a population-based study.
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DOI:
10.5555/uri:pii:003960608290174x
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发表时间:
1982-12
期刊:
影响因子:
3.8
通讯作者:
L. Bickerstaff;P. Pairolero;L. Hollier;L. J. Melton;H. J. Peenen;K. Cherry;J. Joyce;J. Lie
L. Bickerstaff;P. Pairolero;L. Hollier;L. J. Melton;H. J. Peenen;K. Cherry;J. Joyce;J. Lie
中科院分区:
医学2区
文献类型:
--
作者:
L. Bickerstaff;P. Pairolero;L. Hollier;L. J. Melton;H. J. Peenen;K. Cherry;J. Joyce;J. Lie

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在一个稳定的中西部社区的72名居民(44名女性和28名男性)中检测到胸主动脉瘤,超过30年,年龄和性别调整的发病率为每10万人年5.9例新发动脉瘤。男女发病率相同,30年来略有下降。年龄范围为47至93岁(男性中位数为65岁,女性为77岁)。其中升主动脉受累37例,主动脉弓受累8例,降主动脉受累27例。51例患者行病理检查。病因为主动脉夹层27例(53%),动脉粥样硬化15例(29%),动脉炎4例(8%),囊状中膜坏死3例(6%),梅毒2例(4%)。所有尸检的病人有病理证据的显着高血压。11例患者(25%)合并腹主动脉瘤。破裂53例(74%),死亡50例。这些患者中有37例既往未诊断出动脉瘤。其余16例患者的诊断和破裂之间的中位间隔为2年(范围1个月至16年)。95%的主动脉夹层破裂,51%的非夹层动脉瘤破裂。所有72例患者的5年生存率为13%,主动脉夹层患者为7%,无夹层患者为19.2%。
Thoracic aortic aneurysms were detected in 72 residents (44 women and 28 men) in a stable midwestern community over a 30-year period, for an age- and sex-adjusted incidence of 5.9 new aneurysms per 100,000 person-years. The incidence was equal in both sexes and decreased slightly over the 30 years. Ages ranged from 47 to 93 years (median 65 years for men and 77 years for women). The ascending aorta was involved in 37 patients, the aortic arch in 8, and the descending aorta in 27. Pathologic examination was performed in 51 patients. The cause was aortic dissection in 27 patients (53%), atherosclerosis in 15 (29%), aortitis in 4 (8%), cystic medial necrosis in 3 (6%), and syphilis in 2 (4%). All autopsied patients had pathologic evidence of significant hypertension. Eleven patients (25%) had concomitant abdominal aortic aneurysms. Rupture occurred in 53 patients (74%) and 50 died. Thirty-seven of these patients had no prior diagnosis of aneurysm. The median interval between diagnosis and rupture in the 16 remaining patients was 2 years (range 1 month to 16 years). Ninety-five percent of aortic dissections ruptured and 51% of nondissecting aneurysms ruptured. The actuarial 5-year survival for all 72 patients was 13%; for patients with aortic dissection, 7% and for patients without dissection, 19.2%.