JACC:主动脉扩张,有一则容易有二!

2021-07-21 MedSci原创 MedSci原创

任何节段主动脉扩张的最主要预测因素是其他部位的主动脉扩张

主动脉的任何一段都可能发生主动脉扩张(扩张和动脉瘤)。不同部位的主动脉扩张,其病理机制可能不同。尽管存在这种差异,但指南建议,如果发现某一主动脉节段扩张,应对整个主动脉进行筛查

本研究的目的是确定升主动脉、主动脉弓、降主动脉和腹主动脉扩张的最主要预测因素,并建立各主动脉节段的综合危险因素谱。

随机选择60-74岁的个体参加DANCAVAS ItII(丹麦血管多中心筛选试验)。评估了受试者的心血管风险,包括血液样本、血压、医疗记录和非对比计算机断层扫描。通过多变量logistic分析估计扩张的潜在危险因素的调整优势比。

总体上,共纳入了14989位受试者(14235位男性和754位女性),平均68±4岁。当患者存在一节段以上主动脉扩张时,该患者发生任何节段主动脉扩张的校正优势比最高。其他值得注意的预测因素包括同时存在髂动脉扩张、高血压、体表面积增加、男性、家族因素和心房颤动,这些因素在不同的主动脉部位存在不同的相关组合。吸烟和急性心肌梗死与升主动脉和腹主动脉扩张呈负相关。糖尿病是一种整个主动脉任何节段扩张的共同的保护因素。

综上所述,不同节段的主动脉扩张的危险因素不同。任何节段主动脉扩张的最主要预测因素是其他部位的主动脉扩张。该研究结果支持当下指南所推荐的——当发现局灶性主动脉扩张时,建议对主动脉进行全面筛查。

原始出处:

Obel Lasse M,Diederichsen Axel C,Steffensen Flemming H et al. Population-Based Risk Factors for Ascending, Arch, Descending, and Abdominal Aortic Dilations for 60-74-Year-Old Individuals.[J] .J Am Coll Cardiol, 2021, 78: 201-211. https://doi.org/10.1016/j.jacc.2021.04.094

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    2022-03-20 hbwxf
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    2022-03-30 lsj637
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