Gindera L B, Donas K P, Torsello G, Bisdas T, Stavroulakis K
Department of Vascular and Endovascular Surgery, St. Franziskus Hospital University, Münster, Germany -
Minerva Chir. 2015 Dec;70(6):409-16. Epub 2015 Apr 28.
Aim of the study was to determine and compare the incidence of simple renal cysts (SRCs) and abdominal/inguinal wall hernias (AWHs/IHs) in patients with known abdominal aortoiliac aneurysm (AAA) and aortoiliac occlusive disease (AOD) in order to assess if these comorbidities could be promoted as added high risk factors for AAA development.
Prospectively collected clinical and radiological data of 236 AAA patients, treated at our institution between June 2009 and June 2012, were retrospectively analyzed regarding the number, location and type of SRCs and AWHs. Two hundred thirty-six randomly chosen patients with aortoiliac occlusive disease (AOD) were recruited as control group.
SRCs and AWHs were significantly more frequent in the AAA group than in AOD group (68.6% vs. 37.3%, OR=2.110, 95%-CI 1.325-3.359, P=0.002 and 45.3% vs. 24.2%, OR=1.850, 95%-CI 1.153-2.968, P=0.011). In 30.1% of AAA patients both clinical entities were simultaneously detected (OR=2.441, 95%-CI 1.342-4.437, P=0.003), the comorbidity of SRCs and IHs was related to a 3.6-fold increased risk for a coexisting AAA (OR=3.558, 95%-CI 1.622-7.805, P=0.002).
The findings of this study contribute to the clinical evidence of a significant coexistence of SRCs and AWH/IHs in AAA patients. However, further clinical screening trials and research are necessary to establish the clinical significance of this observation and to assess a possible common pathogenesis of systemic extracellular matrix degeneration in affected individuals.
本研究旨在确定并比较已知腹主动脉髂动脉瘤（AAA）和腹主动脉髂动脉闭塞性疾病（AOD）患者中单纯肾囊肿（SRC）和腹/腹股沟壁疝（AWH/IH）的发生率，以评估这些合并症是否可作为AAA发生的新增高危因素。
回顾性分析2009年6月至2012年6月在我院接受治疗的236例AAA患者的前瞻性收集的临床和放射学数据，包括SRC和AWH的数量、位置和类型。随机选取236例腹主动脉髂动脉闭塞性疾病（AOD）患者作为对照组。
AAA组中SRC和AWH的发生率显著高于AOD组（68.6%对37.3%，OR=2.110，95%置信区间1.325 - 3.359，P=0.002；45.3%对24.2%，OR=1.850，95%置信区间1.153 - 2.968，P=0.011）。在30.1%的AAA患者中同时检测到这两种临床情况（OR=2.441，95%置信区间1.342 - 4.437，P=0.003），SRC和IH的合并症与AAA共存风险增加3.6倍相关（OR=3.558，95%置信区间1.622 - 7.805，P=0.002）。
本研究结果为AAA患者中SRC与AWH/IH显著共存提供了临床证据。然而，需要进一步的临床筛查试验和研究来确定这一观察结果的临床意义，并评估受影响个体中系统性细胞外基质退变可能的共同发病机制。
