Stanford A 型主动脉夹层住院死亡相关危险因素的CTA形态学分析

张雪凤; 刘崎; 郝楠馨; 陆建平; 邵成伟; 弓静

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (7) : 462-465.

论著

Stanford A 型主动脉夹层住院死亡相关危险因素的CTA形态学分析

张雪凤1，刘崎1，郝楠馨2，陆建平1，邵成伟1，弓静1

作者信息 +

Risk factors of hospital mortality in Stanford type A aortic dissection according to CTA morphological study

ZHANG Xue-feng1, LIU Qi1, HAO Nan-xin2, LU Jian-ping1, SHAO Cheng-wei1, GONG Jing1

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摘要

目的：对A型主动脉夹层患者主动脉CTA形态学特征进行综合分析，探讨A型主动脉夹层患者住院死亡相关危险因素，为临床预测夹层患者死亡及制定合理的治疗方案提供影像学依据。方法：回顾性分析2011年2月—2013年2月长海医院符合研究要求的47例A型主动脉夹层住院患者全主动脉CTA检查资料，分为死亡组（n=12）及对照组（n=35），利用Vitrea FX图像后处理工作站，对CTA原始图像进行后处理，测量并分析患者住院死亡相关形态学参数，通过单因素及多因素Logistic回归分析探讨A型主动脉夹层患者住院死亡形态学相关危险因素。结果：A型主动脉夹层最大层面主动脉长径（Wald χ2=5.839，P=0.016，OR=1.102）、分支血管累及数量（Wald χ2=4.594，P=0.032，OR=1.337）两个形态学参数与A型夹层患者住院死亡危险因素相关，两者均为危险因素。结论：A型主动脉夹层最大层面主动脉长径、分支血管累及数量两个形态学参数是A型夹层患者住院死亡相关危险因素，较大的主动脉内径及分支血管累及数目多提示临床医生应争取治疗时间。

Abstract

Objective: To explore the risk factors of hospital mortality in Stanford type A aortic dissection by analyzing its morphologic characteristics on CTA and thus try to design a rational treatment planning. Method: The imaging data of computed tomography angiography(CTA) from February 2011 and February 2013 in Changhai hospital in 47 patients with Stanford type A aortic dissection were analyzed retrospectively. All the patients were divided into death group(n=12) and control group(n=35), and all CTA images were reconstructed under Vitrea FX workstation, then measured and analyzed the morphological parameters related to hospital mortality by univariate and multivariate Logistic regression model and to analyse risk factors associated with hospital mortality of type A dissection. Result: There were two morphological parameters, including diameter at maximum(Wald χ2=5.839, P=0.016, OR=1.102) area level of aorta and number of involved branches(Wald χ2=4.594, P=0.032, OR=1.337) related with hospital mortality of type A dissection patients, both parameters were risk factors. Conclusion: The transverse diameter at maximum area level of type A dissection and the number of branching vessels involved by dissection are risk factors associated with hospital mortality. It is adovocated that patients with bigger length of aortic dissection and more branched vessels involved should be treated more actively.

导出引用

张雪凤;刘崎;郝楠馨;陆建平;邵成伟;弓静. Stanford A 型主动脉夹层住院死亡相关危险因素的CTA形态学分析[J]. 中国临床医学影像杂志. 2014, 25(7): 462-465

ZHANG Xue-feng;LIU Qi;HAO Nan-xin;LU Jian-ping;SHAO Cheng-wei;GONG Jing. Risk factors of hospital mortality in Stanford type A aortic dissection according to CTA morphological study[J]. Journal of China Clinic Medical Imaging. 2014, 25(7): 462-465

中图分类号： Ｒ543.1 R814.42 Ｒ814.43