Pleumeekers H J, De Gruijl A, Hofman A, Van Beek A J, Hoes A W
Department of General Practice, Erasmus University Medical School, Rotterdam, The Netherlands.
Br J Surg. 1999 Sep;86(9):1155-8. doi: 10.1046/j.1365-2168.1999.01213.x.
Population-based screening for abdominal aortic aneurysm (AAA) is still a subject of debate. This study examined whether subjects with a history of inguinal hernia were at increased risk sufficient to justify screening.
The prevalence of AAA was documented in 156 men aged 55 years and older, discharged after inguinal hernia surgery, and compared with the prevalence in 1771 men without a history of inguinal hernia who were participating in a screening survey for AAA. The influence of age and smoking status was assessed.
The prevalence of AAA in men with a history of inguinal hernia was 12.2 (95 per cent confidence interval (c.i.) 7.0-17.4) per cent and 3.7 (95 per cent c.i. 2.8-4.6) per cent in those without such a history; prevalence ratio 3.3 (95 per cent c.i. 2.0-5.3). In current smokers the prevalence of abdominal aneurysm was 4.2 (95 per cent c.i. 2.1-8.2) times higher in those with compared with those without a history of inguinal hernia. In non-smokers the prevalence ratio was 1.9 (95 per cent c.i. 0.5-7.0).
Men with a history of inguinal hernia are at increased risk of AAA, most notably if they are cigarette smokers. Ultrasonographic screening could be considered before operation for inguinal hernia.
基于人群的腹主动脉瘤（AAA）筛查仍是一个有争议的话题。本研究探讨有腹股沟疝病史的受试者患AAA风险增加是否足以证明进行筛查是合理的。
记录156例年龄在55岁及以上、腹股沟疝手术后出院的男性中AAA的患病率，并与1771例无腹股沟疝病史且参与AAA筛查调查的男性的患病率进行比较。评估年龄和吸烟状况的影响。
有腹股沟疝病史的男性中AAA患病率为12.2%（95%置信区间（c.i.）7.0 - 17.4），无此病史者为3.7%（95% c.i. 2.8 - 4.6）；患病率比为3.3（95% c.i. 2.0 - 5.3）。在当前吸烟者中，有腹股沟疝病史者腹主动脉瘤患病率比无此病史者高4.2倍（95% c.i. 2.1 - 8.2）。在不吸烟者中，患病率比为1.9（95% c.i. 0.5 - 7.0）。
有腹股沟疝病史的男性患AAA的风险增加，尤其是吸烟者。在进行腹股沟疝手术前可考虑超声筛查。
