Poon Jensen T C, Cheng Stephen W K, Wong Joyce S W, Ting Albert C W
Division of Vascular Surgery, Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Hong Kong.
ANZ J Surg. 2010 Sep;80(9):630-3. doi: 10.1111/j.1445-2197.2010.05345.x.
The Asian population is believed to have lower incidence of abdominal aortic aneurysm (AAA), and hence, the benefit of screening is uncertain. The size of native aorta in Asians, which shall affect the definition of AAA, has also never been reported. Our study investigated the prevalence of AAA and the infra-renal aortic diameter (AD) in Chinese patients with severe coronary artery disease.
This is a prospective observational study of infra-renal aortic size for patients who had coronary artery bypass surgery by ultrasound. The patients' demographics, important co-morbidities and maximum AD were recorded.
The study included 624 consecutive Chinese patients (mean age = 63.2 years). The mean maximum infra-renal AD was 17.5 mm for men and 14.8 mm for women. The presence of AAA was defined as maximum AD greater than 30 mm. The result was also compared with an alternate definition that defines AAA as maximum AD of greater than 1.5 times of the group's mean. Eleven patients had an AD greater than 30 mm, and the prevalence of AAA was only 1.8%. With AAA defined as maximum AD of 1.5 times greater than the group's mean, 19 patients had AAA. The prevalence of AAA in this high-risk group would become 3% overall.
The prevalence of AAA in Chinese patients was low, and the result did not support routine screening. The smaller mean infra-renal AD in Chinese merits validation by large-scale study and consideration when deciding threshold for small AAA repair in our locality.
一般认为亚洲人群腹主动脉瘤（AAA）的发病率较低，因此，筛查的益处尚不确定。亚洲人主动脉的大小会影响AAA的定义，但此前从未有过相关报道。我们的研究调查了中国重症冠状动脉疾病患者中AAA的患病率以及肾下腹主动脉直径（AD）。
这是一项对接受冠状动脉搭桥手术患者的肾下腹主动脉大小进行的前瞻性观察研究。记录患者的人口统计学资料、重要合并症以及最大AD。
该研究纳入了624例连续的中国患者（平均年龄 = 63.2岁）。男性的平均最大肾下腹主动脉直径为17.5毫米，女性为14.8毫米。AAA的定义为最大AD大于30毫米。结果还与另一种将AAA定义为最大AD大于该组平均值1.5倍的定义进行了比较。11例患者的AD大于30毫米，AAA的患病率仅为1.8%。将AAA定义为最大AD大于该组平均值1.5倍时，有19例患者患有AAA。该高危组中AAA的总体患病率将变为3%。
中国患者中AAA的患病率较低，该结果不支持进行常规筛查。中国人较小的平均肾下腹主动脉直径值得通过大规模研究进行验证，并在确定本地小AAA修复阈值时予以考虑。
