摘要
目的 探讨急性Stanford B型主动脉夹层(ABAD)患者发生氧合障碍(OI)的危险因素。方法 收集2018年1月至2021年11月于天津市第四中心医院及天津医科大学总医院就诊的112例ABAD患者的临床资料,按照动脉血氧分压/吸入氧分数的比值PaO_(2)/FiO_(2)的不同将其分为OI组(n=30,PaO_(2)/FiO_(2)≤200 mmHg)(1 mmHg=0.133 kPa)和非OI组(n=82,Pa O_(2)/F i O_(2)﹥200 mmHg),分析ABAD患者发生OI的危险因素。结果 OI组患者体重指数(BMI)、血糖水平、D-二聚体入院时及峰值水平、峰值温度、夹层假腔比例、胸腔积液均高于非OI组患者,差异均有统计学意义(P﹤0.05)。多因素分析结果显示,BMI﹥26.0 kg/m^(2)、假腔比例﹥61.0%、胸腔积液均是ABAD患者发生OI的独立危险因素(P﹤0.05)。结论 肥胖(BMI﹥26.0 kg/m^(2))、夹层真腔严重受压(假腔比例﹥61.0%)及胸腔积液均是预测ABAD患者发生OI的独立危险因素,这些指标有助于预测ABAD患者发生OI的风险,指导适当的药物治疗及尽早外科干预,有助于获得良好的预后。
Objective To explore the risk factors of oxygenation impairment in(OI)acute Stanford type B aotic dissection(ABAD).Method The clinical data of ABAD patients in the Tianjin 4rd Central Hospital and Tianjin Medical University General Hospital from January 2018 to November 2021 were collected.The patients were divided into OI group(n=30,PaO2/FiO2≤200 mmHg)(1 mmHg=0.133 kPa)and non-OI group(n=82,PaO2/FiO2>200 mmHg)according to the ratio of arterial partial oxygen pressure to inhaled oxygen fraction(PaO2/FiO2),that was oxygenation index.The risk factors of OI in ABAD patients were analyzed.Result The body mass index(BMI),blood glucose level,D-dimer at admission and peak level,false lumen ratio,pleural effusion in OI group were higher than those in non-OI group(P<0.05).The results of multivariate analysis showed that BMI>26.0 kg/m^(2),false lumen ratio>61.0%and pleural effusion were independent risk factors for OI in ABAD patients(P<0.05).Conclusion Obesity(BMI>26.0 kg/m^(2)),severe compression of true lumen (false lumen ratio>61.0%) and pleural effusion are independent risk factors for OI in ABAD patients. These indicators are helpful to predict the risk of OI in ABAD patients, guide appropriate medicine treatment and early surgical intervention to obtain good prognosis.
作者
赵路静
李志刚
王峥
朱杰昌
Zhao Lujing;Li Zhigang;Wang Zheng;Zhu Jiechang(Department of Emergency,Tianjin 4rd Central Hospital,Tianjin 300142,China;Department of Vascular Surgery,Tianjin Medical University General Hospital,Tianjin 300052,China)
出处
《血管与腔内血管外科杂志》
2023年第10期1178-1182,共5页
Journal of Vascular and Endovascular Surgery
基金
天津市卫生健康科技项目(ZC20189)。
