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中国主动脉夹层注册研究中急性主动脉夹层的临床特征

Clinical features of acute aortic dissection from the Registry of Aortic Dissection in China.

作者信息

Wang Weiguang, Duan Weixun, Xue Yang, Wang Ling, Liu Jincheng, Yu Shiqiang, Yi Dinghua

机构信息

Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.

State Key Laboratory of Military Stomatology, Department of Oral Biology, School of Stomatology, Fourth Military Medical University, Xi'an, Shaanxi, People's Republic of China.

出版信息

J Thorac Cardiovasc Surg. 2014 Dec;148(6):2995-3000. doi: 10.1016/j.jtcvs.2014.07.068. Epub 2014 Aug 4.

Abstract

OBJECTIVE

To establish a systematic registry of aortic dissection in China, assess the clinical features of Chinese patients with acute aortic dissection (AAD), and compare our results with the data published by the International Registry of Acute Aortic Dissection (IRAD).

METHODS

We established the first Registry of Aortic Dissection in China (Sino-RAD) in 2011. Then we evaluated 1003 patients with AAD in Sino-RAD and compared our results with those reported by IRAD.

RESULTS

Compared with IRAD, the patients with AAD in Sino-RAD were significantly younger. Also, the ratio of male patients in Sino-RAD was significantly greater for the total cohort and the type A and B cohorts. The overall in-hospital mortality was 10.3% in Sino-RAD. For type A dissection, more patients in Sino-RAD received medical treatment and fewer received surgical treatment. The overall mortality, mortality of medical treatment, and mortality of surgical treatment was lower in Sino-RAD. In type B dissection, fewer patients in Sino-RAD received medical and surgical treatment and more received endovascular treatment.

CONCLUSIONS

The first Sino-RAD, including 15 large cardiovascular centers throughout China, was established. Our data were compared with those reported by IRAD. We found that, compared with Western populations, Chinese patients with AAD showed 6 differences, including earlier onset, more male patients, a low incidence of hypertension, a low incidence of chest pain, a high incidence of back pain, great differences in the choice of therapeutic strategies, and relatively low in-hospital mortality.

摘要

目的

在中国建立一个主动脉夹层的系统登记处,评估中国急性主动脉夹层(AAD)患者的临床特征,并将我们的结果与国际急性主动脉夹层登记处(IRAD)公布的数据进行比较。

方法

我们于2011年建立了中国首个主动脉夹层登记处(Sino-RAD)。然后我们评估了Sino-RAD中的1003例AAD患者,并将我们的结果与IRAD报告的结果进行比较。

结果

与IRAD相比,Sino-RAD中的AAD患者明显更年轻。此外,Sino-RAD中男性患者在总队列以及A型和B型队列中的比例明显更高。Sino-RAD的总体住院死亡率为10.3%。对于A型夹层,Sino-RAD中接受药物治疗的患者更多,接受手术治疗的患者更少。Sino-RAD的总体死亡率、药物治疗死亡率和手术治疗死亡率更低。在B型夹层中,Sino-RAD中接受药物和手术治疗的患者更少,接受血管内治疗的患者更多。

结论

首个包括中国15个大型心血管中心的Sino-RAD建立。我们的数据与IRAD报告的数据进行了比较。我们发现,与西方人群相比,中国AAD患者表现出6点差异,包括发病更早、男性患者更多、高血压发病率低、胸痛发病率低、背痛发病率高、治疗策略选择差异大以及住院死亡率相对较低。

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