摘要
目的探讨腹主动脉瘤（AAA）发病的临床流行病学特点及影响预后的相关因素。方法回顾性分析中国医科大学附属第一医院1988-2007年收治的375例AAA患者临床资料，应用Cox比例风险回归模型分析各相关因素与预后的关系。结果肾下AAA患者共375例，患者平均年龄（62±15）岁。男性患者282例，女性93例，男女比例3．03：1。男性中破裂性AAA（14．5％）多于女性（6．5％）（P〈0．05），5年存活率男性组（65．7％）低于女性组（83．3％）（P〈0．01）；≥65岁组破裂率（3．6％）明显低于〈65岁组（17．7％）（P〈0．05），≥65岁年龄组5年生存率（80．4％）优于〈65岁组（64．2％）（P〈0．025）；非高血压组5年生存率（77．4％）优于高血压组（60．6％）（P〈0．05）。最近10年中国医科大学附属第一医院收治肾下AAA患者比前一个10年增加186．6％，且患者瘤体直径缩小（P〈0．01），但动脉瘤破裂发生率差异无统计学意义（P〉0．5）。应用Cox回归分析显示性别（P〈0．05）、入院前吸烟（P〈0．05）和高血压（P〈0．05）3个危险因素影响腹主动脉瘤患者预后；而年龄、治疗方式的选择等因素与AAA患者预后无明显相关性。结论AAA发病率呈上升趋势。男性、吸烟、高血压AAA患者不仅临床表现较为严重，而且预后较差；年龄、治疗方式的选择等因素与AAA患者预后无明显相关性。
Objective To investigate the clinico-epidemiology features of infrarenal abdominal aortic aneurysm （AAA） and relevant prognostic factors. Methods The clinical records of 375 infrarenal AAA patients, 282 males and 93 females, aged （62 ± 15）, hospitalized 1988 - 2007were analyzed. Results In recent ten years, the number of patients admitted because of AAA was 186.6% as high as that in the last 10 years The rupture rate of the male AAA patients was 14. 4%, significantly higher than that of the female AAA patients （6. 5%, P 〈0.05 ）. The rupture rate of the AAA aged patients ≥65 was 3.6%, significantly lower than that of the AAA patients 〈65 （17.7%, P 〈0. 01 ）. The aneurysm diameter of the patients with hyperextension was （6. 1 ± 3.3） cm, significantly lower than that of the patients without hypertension [ （6.8 ± 2. 3 ） cm. P 〈 0. 05 ]. The general 5-year survival rate was 70. 1%. The 5-year survival rates of the female patients, patients ≥ 65, without hypertension, and without coronary heart disease were, all significantly higher than those of the male patients, patients 〈 65, and patients with hypertension or coronary heart disease （all P 〈 0. 05 ）. Cox regression analysis showed that sex, smoking, and hypertension were all prognostic factors （ all P 〈 0.05）. Conclusion The morbidity of AAA increases fiercely. The AAA patients being male, smoking, or with hypertension have poorer prognosis, and age and operation method are not related to prognoses.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2008年第23期1613-1617,共5页
National Medical Journal of China
基金
国家自然科学基金资助项目（30471706）
辽宁省教育厅高等学校科研基金资助项目（20201344）
关键词
主动脉瘤
腹
回顾性研究
危险因素
预后
Aortic aneurysm, abdominal
Retrospectiue studies
Risk factors
Prognosis
