摘要
目的 分析原发性高血压患者主动脉夹层(AD)的血管钙化(VC)特点。方法 选择2010年1月至2015年12月于中山大学孙逸仙纪念医院住院的原发性高血压并经过主动脉计算机断层扫描血管造影(CTA)确诊为AD的30例患者为AD组,原发性高血压且主动脉CTA提示无主动脉病变者30例为对照组。通过CTA和Agatston评分系统分析2组人群以及不同Stanford类型AD患者之主动脉钙化特点。结果 与对照组比较,AD组降主动脉VC发生率升高(P<0.05),主动脉弓VC发生率下降(P<0.05)。2组Agatston评分及不同程度VC发生率的差异无统计学意义(均P>0.05)。AD组患者分为Stanford A型及Stanford B型2个亚组。2个亚组的临床资料、主动脉及不同部位VC发生率差异无统计学意义(均P>0.05)。多因素Logistic回归分析显示,与AD病变相关的因素有:低密度脂蛋白胆固醇(OR=3.397,95%CI 1.234~9.354,P=0.018)、不规律服用降压药(OR=20.417,95%CI 2.326~179.233,P=0.006)、主动脉弓VC发生率(OR=0.027,95%CI 0.002~0.357,P=0.006)及降主动脉VC发生率(OR=35.606,95%CI 2.475~512.27,P=0.009)。结论 原发性高血压患者主动脉不同部位钙化特点不同可能是高血压促进AD病变的重要环节。
Aim To analyze the characteristics of vascular calcification (VC) in aortic dissection (AD) of patients with essential hypertension.Methods From January 2010 to December 2015, 30 patients with essential hypertension diagnosed as AD by computed tomography angiography (CTA) in Sun Yat-sen Memorial Hospital of Sun Yat-sen U-niversity were selected as the AD group, and 30 cases of essential hypertension and aortic CTA showed no aortic disease were as the control group.Characteristics of aortic calcification in two groups of people and patients with different Stanford types of AD were analyzed by CTA and Agatston scoring system.Results Compared with the control group, the VC incidence of descending aorta increased and the VC incidence of aortic arch decreased in AD group (P<0.05).There was no significant difference between the two groups in the Agatston score and the incidence of VC with different degrees (P>0.05).Patients in group AD were divided into two subgroups: Stanford A type and Stanford B type.There was no significant differences in the clinical data and the incidences of VC in aorta and different parts of the two subgroups (P>0.05).Multivariate Logistic regression analysis showed that the factors associated with AD lesions were: low density lipoprotein cholesterol (OR 3.397, 95%CI 1.234-9.354, P=0.018), irregular use of antihypertensive drugs (OR 20.417, 95%CI2.326-179.233, P = 0-006), VC incidence of aortic arch (OR 0.027, 95%CI 0.002-0.357, P=0.006) and VC incidence of descending aorta (OR 35.606, 95%CI 2.475-512.27,P =0.009).Conclusion The differences of calcification in different parts of aorta in patients with essential hypertension may be an important link of hypertension in promoting AD lesion.
作者
袁要欢
高明
陈洁
曾宽
冯伟镜
何婉冰
聂如琼
杨艳旗
王景峰
黄辉
YUAN Yaohuan;GAO Ming;CHEN Jie;ZENG Kuan;FENG Weijing;HE Wanbing;NIE Ruqiong;YANG Yan-qi;WANG Jingfeng;HUANG Hui(Department of Cardiology,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,,Guangzhou,Guangdong 510000,China;Department of General Practice,Community Health Service Center of Longjin Street,Liwan District,Guangzhou,Guangdong 510000,China)
出处
《中国动脉硬化杂志》
CAS
2018年第11期1106-1110,共5页
Chinese Journal of Arteriosclerosis
基金
国家自然科学基金面上项目(81670676)
关键词
原发性高血压
主动脉夹层
血管钙化
essential hypertension
aortic dissection
vascular calcification
