Scott R A P, Bridgewater S G, Ashton H A
Scott Research Unit, St Richard's Hospital, Chichester PO19 4SE, UK.
Br J Surg. 2002 Mar;89(3):283-5. doi: 10.1046/j.0007-1323.2001.02014.x.
Screening for abdominal aortic aneurysm (AAA) is commonly restricted to men. Recent studies have indicated a possible increase in deaths due to ruptured AAA in women, and a higher rate of rupture in women than in men. The present report details results from a randomized controlled trial that assessed the effects of screening women for AAA.
Some 9342 women aged 65-80 years were entered into the trial and randomized to age-matched screen and control groups. A single ultrasonographic scan was offered to women in the screening arm of the study. Women with an AAA received follow-up scans, and were considered for elective surgery if certain criteria were met.
The prevalence of AAA was six times lower in women (1.3 per cent) than in men (7.6 per cent). Over 5- and 10-year follow-up intervals, the incidence of rupture was the same in the screened and control groups of women.
Screening women for AAA is neither clinically indicated nor economically viable.
腹主动脉瘤(AAA)筛查通常仅限于男性。近期研究表明,女性因AAA破裂导致的死亡人数可能增加,且女性的破裂率高于男性。本报告详细介绍了一项随机对照试验的结果,该试验评估了对女性进行AAA筛查的效果。
约9342名65至80岁的女性参与了该试验,并被随机分为年龄匹配的筛查组和对照组。对研究筛查组的女性进行了一次超声扫描。患有AAA的女性接受了后续扫描,如果符合某些标准,则考虑进行择期手术。
女性AAA的患病率(1.3%)比男性(7.6%)低六倍。在5年和10年的随访期内,筛查组和对照组女性的破裂发生率相同。
对女性进行AAA筛查既无临床指征,在经济上也不可行。