CLINICAL FEATURES AND PROGNOSIS IN DISSECTING ANEURYSM OF AORTA - A RE-APPRAISAL
CLINICAL FEATURES AND PROGNOSIS IN DISSECTING ANEURYSM OF AORTA - A RE-APPRAISAL
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DOI：
10.1161/01.cir.35.5.880
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发表时间：
1967-01-01
期刊：
影响因子：
37.8
通讯作者：
HURST, JW
中科院分区：
文献类型：
--
作者：
LINDSAY, J;HURST, JW
本文对62例经手术证实的主动脉夹层患者的临床特点及预后进行了回顾性分析。这是一家大型综合医院近17年来的连续经验。在疾病过程中升主动脉未受损的患者中，初始和长期生存率要好得多。已知存在这种累及的患者均未存活超过3周。19例患者中，有8例患者的疾病开始于主动脉弓远端，已知已存活6至69个月，尽管其中6例未手术。两组的临床表现也存在显著差异。主动脉瓣返流，桡动脉或颈动脉搏动受损，神经系统体征，而在左锁骨下动脉以外开始剥离的组中，低血压罕见。在该组中经常观察到显著的全身性高血压，超过1/3的舒张压超过140 mm Hg，近2/3的舒张压超过120 mm Hg。当升主动脉是疾病的起源时，这种高血压是不寻常的。尽管目前的研究，现有的数据不允许任何明确的结论，任何形式的治疗这种疾病的疗效。
The records of 62 patients on whom the diagnosis of aortic dissection was proved are reviewed with particular attention to the clinical features and prognosis in each case. This was the consecutive experience of a large general hospital over approximately 17 years. The initial and long-term survival was far better in patients in whom the ascending aorta was spared by the disease process. No patients in whom such involvement was present were known to survive more than 3 weeks. Eight of 19 patients whose disease began distal to the arch of the aorta are known to have survived 6 to 69 months even though 6 of these 8 were not operated on. Striking differences in the clinical findings of the 2 groups were also found. Aortic regurgitation, impairment of a radial or carotid pulse, neurological signs, and hypotension were rare in the group whose dissection began beyond the left subclavian artey. Marked systemic hypertension was frequently observed in this group, over 1/3 having a diastolic pressure over 140 mm Hg and nearly 2/3 over 120 mm Hg. Such hypertension was unusual when the ascending aorta was the origin of the disease. Despite the present study the available data do not allow any definite conclusions about the efficacy of any form of therapy of this disorder.