急性主动脉夹层死亡的危险因素分析-内科学专业论文.docxVIP

— — PAGE 1— 摘 要 急性主动脉夹层死亡的危险因素分析 研究生：郝明辉 导师：买苏木·马合木提 副教授 摘 要 目的:分析急性主动脉夹层院内死亡的危险因素。方法:采用回顾性分析方法分析 2002~2009年资料完整的304例急性主动脉夹层病例,使用Logistic 回归分析年龄、性 别、病因、临床症状及体征、治疗方法的选择与急性主动脉夹层的临床病死率的关 系。 结果 : ① 304 例患者中 ( 男 227 例 , 女 77 例 ) 男女性别之比为 2.9:1 ，平均年龄 (54.31±14.24) 岁，②总体临床病死率为18.4 %。其中按Debakey分型, DebakeyⅠ型患 者临床病死率为42.8% , DebakeyⅡ型患者临床病死率8.70%,DebakeyⅢ型患者临床病 死率为4.37 %。③ Logistic 回归分析示:主动脉瓣返流(P = 0.005,OR=4.450)、急性肾 功能不全或一过性肌酐升高 (P=0.022, OR=3.282) 、心包积液或心包填塞 (P= 0.004,OR=3.957) 、局部肢体缺血(任一肢体) (P = 0.001,OR=4.267)、DebakeyⅠ型(P = 0.000, OR=5.449)、药物保守治疗(P = 0.001,OR=4.721)，为急性主动脉夹层预测死亡 的危险因素。结论:主动脉瓣返流、急性肾功能不全或一过性肌酐升高、急性心包填 塞或心包积液、局部肢体缺血、分型为DebakeyⅠ型、治疗选择药物保守治疗为急性 主动脉夹层的独立死亡危险因素。 关键词：急性主动脉夹层；病死率；危险因素 新疆医科大学医学硕士学位论文 Risk Factor Analysis for Intrahospital Death of Acute Phase of Aortic Dissection Postgratude : Hao Ming-hui Supervisor: Prof. Mai Su-mu Abstract Objective: To analyze the risk factor for intrahospital eath of acute aortic dissection(AD). Methods: Clinical data of 304 patients with AD in the First Affiliated Hospital Xinjiang Medical University fron 2002 to 2009 were analyzed retrospectively. Results: Among 304 cases with AD, the male/female ratio was 2.9:1, the mean age was (54.31±14.24). The intrahospital mortality was 18.4 % in overall patients, the intrahospital mortality of the debakeyⅠpatients was 42.8%;the DebakeyⅡ was 8.70%; the DebakeyⅢ was 4.37%. The regression analysis show that aortic regurgitation (p=0.005 OR=4.450), acute kidney failure (p=0.022, OR=3.282), hydropericardium or cardiac tamponade (p=0.004,OR=3.957), local Limbs ischemia (p=0.001, OR=4.267), DebakeyⅠ(p=0.000, OR=5.449), expectant treatment (p=0.001, OR=4.721). Conclusion: aortic regurgitation, acute kidney failure, hydropericardium or cardiac tamponade, local Limbs ischemia, DebakeyⅠ, expectant treatment were the six independent risk factors of the intrahospital mortality of AD in acute phase. Key words: Acute aortic dissection; Intrahospital mortality; Risk factor 中英文缩略词对照表