儿童和青少年时期的主动脉夹层：纽约州 10 年间发病情况分析。
Aortic dissection in childhood and adolescence: an analysis of occurrences over a 10-year interval in New York State.
机构信息
Caritas Health Care/Mary Immaculate Hospital, Woods Health Sciences Library, Jamaica, New York 11432, USA.
出版信息
Clin Cardiol. 2009 Jun;32(6):E23-6. doi: 10.1002/clc.20383.
BACKGROUND
Rarely occurring in the pediatric and adolescent population, aortic dissection is a condition with many predisposing factors. Previous studies have suggested that congenital cardiovascular disorders are the most common predisposing conditions. Trauma-associated aortic dissection is considered a rare occurrence.
METHODS
The Statewide Planning and Research Cooperative System database of New York State was used to retrieve cases of aortic dissection in persons < or = 21 years old over a 10-year period. A retrospective analysis for risk or associated conditions was undertaken.
RESULTS
Forty-five of a total of 12,142 cases of aortic dissection (0.37%) occurred in persons < or = 21 years old. No patient was younger than 15 years of age. Six of the 45 died (13%). Most patients were male (37 of 45, or 82%). Contrary to previous reports, the most common associated condition was trauma (19 of 45, or 42%), with Marfan syndrome the second most common (11 of 45, or 24%). Ten of 45 adolescent and young adult patients (22%) had no apparent risk factors.
CONCLUSIONS
Traumatic aortic disruptions must be considered in children and adolescents who survive serious chest trauma. Family members of pediatric and young adult patients with trauma-associated aortic dissection may need to be evaluated for possible risk of aortic dissection.
背景
在儿科和青少年人群中很少发生的主动脉夹层是一种有许多诱发因素的疾病。先前的研究表明，先天性心血管疾病是最常见的诱发条件。与创伤相关的主动脉夹层被认为是罕见的。
方法
纽约州全州规划和研究合作系统数据库被用来检索在 10 年内年龄<或=21 岁的主动脉夹层病例。对风险或相关条件进行了回顾性分析。
结果
在总共 12142 例主动脉夹层病例中，有 45 例（0.37%）发生在年龄<或=21 岁的患者中。没有年龄小于 15 岁的患者。45 例患者中有 6 例死亡（13%）。大多数患者为男性（45 例中的 37 例，或 82%）。与以往的报告相反，最常见的相关疾病是创伤（45 例中的 19 例，或 42%），马凡综合征是第二常见的疾病（45 例中的 11 例，或 24%）。45 名青少年和年轻成年患者中有 10 名（22%）没有明显的危险因素。
结论
在严重胸部创伤后幸存的儿童和青少年中，必须考虑创伤性主动脉破裂。创伤相关主动脉夹层的儿科和年轻成年患者的家属可能需要评估主动脉夹层的可能风险。
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