Lindholt J S, Vammen S, Juul S, Fasting H, Henneberg E W
Department of Vascular Surgery, Viborg Hospital, Denmark.
Eur J Vasc Endovasc Surg. 2000 Oct;20(4):369-73. doi: 10.1053/ejvs.2000.1191.
to determine safe and optimal intervals of rescreening and surveillance for AAA.
hospital-based mass screening of 6339 65-73-year-old men from 1994-98. 76.4% attended. One hundred and ninety-one (4%) had AAA53 cm. Twenty-four (0.5%) were initially >5 cm and referred for surgery, while the rest were offered annual control scans to check for expansion. Later, all 348 (7.5%) men who 3 to 5 years ago had an ectatic aorta (infrarenal aortic diameter of 25-29 mm or distal/renal aortic diameter ratio >1.2) were offered rescreening. Of these, 62 (18%) died before rescanning, while 248 of the survivors attended rescreening (87%). Furthermore, a random sample of 380 of those with non-ectatic aortas were offered rescreening. Of these, 49 (13%) died before rescreening (p=0.06), while 275 (83%) of the survivors attended re-screening.
none of the controls had developed AAA. Of those who initially had an 25-29 mm aorta, 29% had developed AAA (size range 30-48 mm) with expansion rates varying from 1.0 to 4.7 mm/year. Only 3.5% with a ratio >1.2 developed AAA (size range: 30-34 mm) with expansion rates from 1.3 to 2.4 mm/year. During the fourth year of surveillance some AAA initially sized below 3.5 cm expanded to above 5 cm, while some sized 3.5-3.9 cm did so during the second year, >4 cm did so during the first year of surveillance.
rescreening for AAA can be restricted to initially ectatic aortas sized 25-29 mm at 5-year intervals. Surveillance of small AAA can be restricted to 1-4 year intervals.
确定腹主动脉瘤再次筛查和监测的安全及最佳间隔时间。
1994年至1998年对6339名65至73岁男性进行基于医院的大规模筛查。76.4%的人参加了筛查。191人（4%）患有腹主动脉瘤，其中53人瘤体直径≥5cm。24人（0.5%）最初瘤体直径＞5cm，被转诊接受手术，其余患者则接受年度对照扫描以检查瘤体是否扩大。后来，对所有348名（7.5%）在3至5年前有主动脉扩张（肾下主动脉直径为25至29mm或远端/肾主动脉直径比＞1.2） 的男性进行再次筛查。其中，62人（18%）在再次筛查前死亡，而248名幸存者参加了再次筛查（87%）。此外，对380名非扩张性主动脉的男性进行随机抽样并提供再次筛查。其中，49人（13%）在再次筛查前死亡（p=0.06），而275名幸存者参加了再次筛查（83%）。
对照组中无人发生腹主动脉瘤。最初主动脉直径为25至29mm的患者中，29%发生了腹主动脉瘤（瘤体大小范围为30至48mm），扩张率为每年1.0至4.7mm。只有3.5%的直径比＞1.2的患者发生了腹主动脉瘤（瘤体大小范围为30至34mm），扩张率为每年1.3至2.4mm。在监测的第四年，一些最初大小＜3.5cm的腹主动脉瘤扩大到＞5cm，而一些大小为3.5至3.9cm的腹主动脉瘤在第二年扩大到＞5cm，＞4cm的腹主动脉瘤在监测的第一年扩大到＞5cm。
腹主动脉瘤的再次筛查可限于最初直径为25至29mm的扩张性主动脉，间隔5年进行一次。小型腹主动脉瘤的监测间隔可限于1至4年。
