JACC:非综合征性胸主动脉夹层动脉瘤临床结果预测

2016-02-11 MedSci MedSci原创

遗传主动脉病(GA)可引起年轻的成年人胸主动脉瘤(TAA)。在非综合征性TAA(NS-TAA)中,具有可比性的生存和结果的预测是可以通过马凡氏综合征(MFS)和二叶主动脉瓣(BAV)不完全定义的。该研究旨在比较NS-TAA,MFS和BAV人群的生存和临床结果。从1988年到2014年,所有患有GA的16-60岁以上的患者被招募进一个临床结果的前瞻性研究中。死亡和主动脉夹层危险因素通过Cox比例风险

遗传主动脉病(GA)可引起年轻的成年人胸主动脉瘤(TAA)。在非综合征性TAA(NS-TAA)中,具有可比性的生存和结果的预测是可以通过马凡氏综合征(MFS)和二叶主动脉瓣(BAV)不完全定义的。

该研究旨在比较NS-TAA,MFS和BAV人群的生存和临床结果。

从1988年到2014年进行的一项前瞻性临床研究,患有GA的16-60岁以上的患者被招募。死亡和主动脉夹层危险因素通过Cox比例风险模型确定,并制定了死亡风险评分。

760例患者被诊断为GA(年龄36.9±13.6岁,26.8%为女性; NS-TAA,n=311; MFS,n =221; BAV,n=228)。MFS患者较NS-TAA和BAV年轻。主动脉夹层在NS-TAA比MFS或BAV更为常见。687例患者术后生存>30天,中位随访时间为7年。计算10年死亡率NS-TAA为7.8%,MFS为8.7%,BAV为3.5%(NS-TAA和MFS vs BAV P<0.05)。与全因死亡率有关的因素是MFS(P=0.04),患病时的年龄和夹层的家族史。

MFS和NS-TAA的临床结果相似,但比BAV更糟糕。死亡率的独立预测因子,包括主动脉夹层家族史和年龄,可以包含在一个Aortopathy死亡风险评分中预测生存。NS-TAA管理,包括外科手术,应该与MFS是类似的。

原始出处:

Andrew G. Sherrah,Sarah Andvik,Denise van der Linde,et al.Nonsyndromic Thoracic Aortic Aneurysm and Dissection,JACC,2016.2.9

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    2016-10-08 hbwxf
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  5. 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  6. 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  8. 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createdName=jiadan198782, createdTime=Fri May 06 21:59:00 CST 2016, time=2016-05-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1898785, encodeId=781d1898e8509, content=<a href='/topic/show?id=729322969b9' target=_blank style='color:#2F92EE;'>#临床结果#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22969, encryptionId=729322969b9, topicName=临床结果)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4fd6156, createdName=oliver169, createdTime=Fri Apr 22 10:59:00 CST 2016, time=2016-04-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1325177, encodeId=375013251e78d, content=<a href='/topic/show?id=96c71804b7' target=_blank style='color:#2F92EE;'>#ACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1804, encryptionId=96c71804b7, topicName=ACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=1e452500029, createdName=12498568m50暂无昵称, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415030, encodeId=134c141503062, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=23, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1430591, encodeId=73e714305912b, content=<a href='/topic/show?id=f9b9e9124a8' target=_blank style='color:#2F92EE;'>#综合征#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519514, encodeId=9476151951409, content=<a href='/topic/show?id=b63a3323558' target=_blank style='color:#2F92EE;'>#动脉夹层#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33235, encryptionId=b63a3323558, topicName=动脉夹层)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae5711287462, createdName=mhzhuang@stu.e, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64151, encodeId=034d64151ab, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=841a1636000, createdName=lietome1, createdTime=Sat Feb 13 11:36:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64152, encodeId=807664152fd, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=841a1636000, createdName=lietome1, createdTime=Sat Feb 13 11:36:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64109, encodeId=6bdc641099a, content=learnt, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 13 09:03:00 CST 2016, time=2016-02-13, status=1, ipAttribution=)]
    2016-02-13 lietome1

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=1853480, encodeId=61481853480f6, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Oct 08 14:59:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003970, encodeId=ceda20039e00d, content=<a href='/topic/show?id=cdac840e95e' target=_blank style='color:#2F92EE;'>#胸主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84079, encryptionId=cdac840e95e, topicName=胸主动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b70c362, 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objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=79124, encryptionId=f9b9e9124a8, topicName=综合征)], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/aLGWoFXAyMbIu3qymFOyheQLjPSX3OUs5GmkyBlcCOwTPIeq3why9NGibxxUqYo6hcx8qZLHZFgNPnBK1yzWeOFpyg2OnWOt0/0, createdBy=fa4716, createdName=zhouqu_8, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1519514, encodeId=9476151951409, content=<a href='/topic/show?id=b63a3323558' target=_blank style='color:#2F92EE;'>#动脉夹层#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=33235, encryptionId=b63a3323558, topicName=动脉夹层)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=ae5711287462, createdName=mhzhuang@stu.e, createdTime=Sat Feb 13 13:59:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64151, encodeId=034d64151ab, content=赞, beContent=null, objectType=article, channel=null, level=null, likeNumber=112, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=841a1636000, createdName=lietome1, createdTime=Sat Feb 13 11:36:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64152, encodeId=807664152fd, content=收藏, beContent=null, objectType=article, channel=null, level=null, likeNumber=128, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=841a1636000, createdName=lietome1, createdTime=Sat Feb 13 11:36:00 CST 2016, time=2016-02-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=64109, encodeId=6bdc641099a, content=learnt, beContent=null, objectType=article, channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 13 09:03:00 CST 2016, time=2016-02-13, status=1, ipAttribution=)]
    2016-02-13 lietome1

    收藏

    0

  10. [GetPortalCommentsPageByObjectIdResponse(id=1853480, encodeId=61481853480f6, content=<a href='/topic/show?id=48351020537' target=_blank style='color:#2F92EE;'>#JACC#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=31, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=10205, encryptionId=48351020537, topicName=JACC)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=55ce62, createdName=hbwxf, createdTime=Sat Oct 08 14:59:00 CST 2016, time=2016-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2003970, encodeId=ceda20039e00d, content=<a href='/topic/show?id=cdac840e95e' target=_blank style='color:#2F92EE;'>#胸主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=32, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=84079, encryptionId=cdac840e95e, topicName=胸主动脉)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=b70c362, 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channel=null, level=null, likeNumber=108, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82311653708, createdName=医者仁心5538, createdTime=Sat Feb 13 09:03:00 CST 2016, time=2016-02-13, status=1, ipAttribution=)]
    2016-02-13 医者仁心5538

    learnt

    0