Department of Colon and Rectum Surgery, Liaoning Cancer Hospital & Institute, Shenyang, Liaoning 110042, China.
Chin Med J (Engl). 2010 May 20;123(10):1255-8.
Inflammatory abdominal aortic aneurysms (IAAAs) are rare but distinct clinical entities of atherosclerotic abdominal aortic aneurysms (aAAAs). In this study we report a 20-year single institution experience for IAAA and analyze their clinical features and long term outcome in comparison with aAAA.
Between 1988 and 2008, 412 cases of abdominal aortic aneurysms (AAAs) underwent elective surgical operations, 11 (2.7%) of whom were diagnosed as IAAAs and 389 (94.4%) were diagnosed as aAAAs. The former group was matched in a case control fashion to a group of 33 patients with aAAAs having similar characteristics of age, gender, and preoperative risk factors. All available clinical, pathologic, and postoperative variables were retrospectively reviewed, and the two groups were compared.
The two groups did not differ significantly in clinical characteristics and preoperative risk factors, although patients with IAAAs were significantly more symptomatic (100% vs. 42.4%, P = 0.001) and had larger aneurysms on admission ((7.4 +/- 0.7) cm vs. (6.3 +/- 0.9) cm, P = 0.006). In IAAAs, the preoperative erythrocyte sedimentation rate was found to be significantly elevated compared to aAAA group ((44.5 +/- 9.1) mm/h vs. (11.4 +/- 5.4) mm/h, P < 0.05). Surgical morbidity and mortality rates did not differ between the two groups. The operation time for patients with IAAAs was significantly longer than that for patients with aAAAs ((308 +/- 36) minutes vs. (224 +/- 46) minutes, P < 0.05), but the cross-clamp time was similar in both groups ((41.5 +/- 6.2) minutes vs. (41.8 +/- 6.2) minutes, P = 0.92). A five-year survival rate analysis showed no significant difference between the two groups (P = 0.711).
Despite having more symptoms, larger size and longer operation time, patients with IAAA can now be treated with approaches that cause low morbidity and mortality, similar to patients with aAAA. Long term outcome of IAAA patients is of no difference from aAAA patients.
炎性腹主动脉瘤（IAAA）是一种罕见但独特的动脉粥样硬化性腹主动脉瘤（aAAA）临床类型。本研究报告了 20 年来单一机构对 IAAA 的经验，并分析了其临床特征和长期结果，同时与 aAAA 进行了比较。
1988 年至 2008 年间，412 例腹主动脉瘤（AAA）患者接受了择期手术治疗，其中 11 例（2.7%）被诊断为 IAAA，389 例（94.4%）被诊断为 aAAA。以前的组以病例对照的方式与一组 33 例具有相似年龄、性别和术前危险因素的 aAAA 患者相匹配。回顾性分析所有可用的临床、病理和术后变量，并对两组进行比较。
两组在临床特征和术前危险因素方面无显著差异，尽管 IAAA 患者的症状更为明显（100% vs. 42.4%，P=0.001），入院时的动脉瘤更大（7.4±0.7）cm vs. （6.3±0.9）cm，P=0.006）。在 IAAA 中，与 aAAA 组相比，红细胞沉降率显著升高（44.5±9.1）mm/h vs. （11.4±5.4）mm/h，P<0.05）。两组的手术发病率和死亡率无差异。IAAA 患者的手术时间明显长于 aAAA 患者（308±36）分钟 vs. （224±46）分钟，P<0.05），但两组的夹闭时间相似（41.5±6.2）分钟 vs. （41.8±6.2）分钟，P=0.92）。5 年生存率分析显示两组无显著差异（P=0.711）。
尽管 IAAA 患者症状更多、瘤体更大、手术时间更长，但现在可以采用导致发病率和死亡率较低的方法进行治疗，与 aAAA 患者相似。IAAA 患者的长期预后与 aAAA 患者无差异。
