Powell J T, Brown L C
Department of Vascular Surgery, Imperial College at Charing Cross, St Dunstan's Road, London W6 8RP.
Acta Chir Belg. 2001 Jan-Feb;101(1):11-6.
The UK Small Aneurysm Trial has shown that ultrasound surveillance is a safe management option for patients with small abdominal aortic aneurysms (4.0 to 5.5 cm in diameter), with an annual rupture rate of only 1%. We investigated baseline risk factors associated with aneurysm rupture in the 1090 trial patients and an additional 1167 patients enrolled in the UK Small Aneurysm Study. In this cohort of 2257 patients there were 103 cases of aneurysm rupture. After 3 years the annual rate of rupture was 2.2% (95% CI 1.7 to 2.8). The risk of rupture was independently and significantly associated with female sex (p < 0.001), larger initial aneurysm diameter (p < 0.001), current smoking (p = 0.01) and higher mean blood pressure (p = 0.01). Age, body mass index, serum cholesterol concentration and ankle/brachial pressure index were not associated with an increased risk of aneurysm rupture. The most surprising finding was that women had a 3-fold higher risk of aneurysm rupture than men. Effective control of blood pressure and cessation of smoking are two simple measures that are likely to diminish the risk of aneurysm rupture and improve the cardiovascular health of patients with abdominal aortic aneurysm.
英国小型动脉瘤试验表明，超声监测对于小型腹主动脉瘤（直径4.0至5.5厘米）患者是一种安全的管理选择，其年破裂率仅为1%。我们调查了1090名试验患者以及另外1167名参与英国小型动脉瘤研究的患者中与动脉瘤破裂相关的基线风险因素。在这2257名患者队列中，有103例动脉瘤破裂病例。3年后，年破裂率为2.2%（95%置信区间1.7至2.8）。破裂风险与女性性别（p<0.001）、初始动脉瘤直径较大（p<0.001）、当前吸烟（p=0.01）以及较高的平均血压（p=0.01）独立且显著相关。年龄、体重指数、血清胆固醇浓度和踝臂压力指数与动脉瘤破裂风险增加无关。最令人惊讶的发现是，女性动脉瘤破裂风险比男性高3倍。有效控制血压和戒烟是两项可能降低动脉瘤破裂风险并改善腹主动脉瘤患者心血管健康的简单措施。
