JACC:急性主动脉夹层报告--诊断以及入院治疗结果的17年趋势

2015-07-21 崔倩 译 MedSci原创

目前急性主动脉夹层(AAD)的诊断、治疗及治疗成果正在发生着变化。本研究对来自于国际急性主动脉夹层的注册表(IRAD)的AAD报告的诊断以及入院治疗结果的17年的发展趋势进行了探讨。      数据来自于1995年12月26日和2013年2月6日之间,28个IRAD中心的4428例患者的数据,并进行了分析。根据患者的招募日期被为数量相等的6组,根据AAD类型被分为

目前急性主动脉夹层(AAD)的诊断、治疗及治疗成果正在发生着变化。本研究对来自于国际急性主动脉夹层的注册表(IRAD)的AAD报告的诊断以及入院治疗结果的17年的发展趋势进行了探讨。
    
数据来自于1995年12月26日和2013年2月6日之间,28个IRAD中心的4428例患者的数据,并进行了分析。根据患者的招募日期被为数量相等的6组,根据AAD类型被分为:A组(n=2952)或B组(n=1476)。
    
对于A型和B型AAD,在有史以来最严重的疼痛报告方面没有变化(分别为93%和94%,),胸痛的发病率也没有变化(分别为83%和71%)。使用计算机断层扫描(CT)用于A型的诊断的从46%提高到73%(P<0.001)。外科治疗A型从79%提高到90%(P<0.001)。 B型的血管内治疗从7%提高到31%(P<0.001)。 A型住院病死率显著下降(31%至22%;P<0.001),手术死亡率也呈现显著下降的趋势(25%至18%,P=0.003)。B型的住院死亡率没有显著的趋势(从12%到14%)。
    
表现症状和AAD的体检结果没有显著变化。利用胸部CT增加了A型的诊断。两组中更多的患者使用介入程序进行管理:A型进行手术,B型进行血管内治疗。A型的整体院内死亡率显著下降,但B型没有。


急性主动脉夹层17年以上趋势。A型(2952例)和B型(1476例)急性主动脉夹层患者基于被招募的时间(1996~2013)被分为数量相等的组。

原始出处:

Linda A. Pape,Mazen Awais, Elise M. Woznicki,Toru Suzuki,et al. Diagnosis, and Outcomes of Acute Aortic Dissection,JACC,2015.7.21

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    2016-02-03 hbwxf
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