Tamori Yuiichi, Akutsu Koichi, Kasai Satoshi, Sakamoto Shingo, Okajima Toshiya, Yoshimuta Tsuyoshi, Yokoyama Naoyuki, Ogino Hitoshi, Higashi Masahiro, Nonogi Hiroshi, Takeshita Satoshi
Department of Cardiovascular Medicine, National Cardiovascular Center, Suita, Japan.
Circ J. 2009 May;73(5):822-5. doi: 10.1253/circj.cj-08-0427. Epub 2009 Mar 18.
Aortic aneurysms are found in 5-20% of patients with acute aortic dissection (AAD). Coexisting aortic aneurysms might potentially influence the incidence of AAD. The purpose of this study was to elucidate the role of coexistent aortic aneurysms in AAD.
A total of 140 patients with AAD were enrolled in the present study. Clinical characteristics of the patients were evaluated in relation to the locations of aortic segments affected by the dissection as well as of the coexistent aortic aneurysm. Among the 140 study patients, 34 (24%) had true aortic aneurysms. Patients with coexistent aortic aneurysm were significantly older than those without (72 +/- 11 years vs 65 +/- 14 years, P=0.012) and had higher incidence of thrombosed false lumen (62% vs 38%, P=0.017), and coronary artery disease (26% vs 8%, P=0.006). Twenty-two of these 34 (65%) patients had a thoracic aortic aneurysm (TAA), and this frequency of TAA was much higher than that observed in the general population. Furthermore, among all patients with AAD, 12 patients (9%) might be associated with development of AAD.
The current study showed that nearly one-quarter of AAD patients had coexisting true aortic aneurysms, and suggests that TAA are likely to be associated with development of AAD.
在急性主动脉夹层（AAD）患者中，5%-20%存在主动脉瘤。并存的主动脉瘤可能会影响AAD的发病率。本研究的目的是阐明并存的主动脉瘤在AAD中的作用。
本研究共纳入140例AAD患者。根据夹层累及的主动脉节段位置以及并存的主动脉瘤情况，对患者的临床特征进行评估。在140例研究患者中，34例（24%）有真性主动脉瘤。并存主动脉瘤的患者比无主动脉瘤的患者年龄显著更大（72±11岁 vs 65±14岁，P=0.012），血栓形成的假腔发生率更高（62% vs 38%，P=0.017），冠状动脉疾病发生率也更高（26% vs 8%，P=0.006）。这34例患者中有22例（65%）有胸主动脉瘤（TAA），TAA的发生率远高于普通人群。此外，在所有AAD患者中，12例（9%）可能与AAD的发生有关。
本研究表明，近四分之一的AAD患者并存真性主动脉瘤，提示TAA可能与AAD的发生有关。
