Opacic Dragan, Ilic Nikola, Sladojevic Milos, Schönleitner Patrick, Markovic Dragan, Kostic Dusan, Davidovic Lazar
1 Herz- und Diabeteszentrum Nordrhein-Westfalen, Bad Oeynhausen, Germany.
2 Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Vasa. 2018 Feb;47(2):137-142. doi: 10.1024/0301-1526/a000681. Epub 2018 Jan 4.
The effect of atmospheric pressure (AP) on the onset of abdominal aorta aneurysm rupture (RAAA) remains an unanswered question. We have investigated the seasonal variation and the effect of AP dynamics on RAAA by analysing the largest series of intraoperatively confirmed RAAA.
To realize this study we have performed a retrospective analysis of 546 patients with RAAA, operated within 503 days at the Clinic for vascular and endovascular surgery CCS between 1.1.2003 and 31.12.2012. AP data for Belgrade city were obtained from meteorological yearbooks published by the Republic Hydrometeorological Service of Serbia measured at the hydrometeorological station "Belgrade Observatory". Only patients with a residence within the extended Belgrade region, exposed to the similar AP values, were included in the analysis of the AP effect on RAAA.
RAAA were observed more frequently during winter and autumn months but without significant difference in comparison to other seasons. Months with higher AP values were associated with a higher RAAA rate (p = 0.0008, R2 = 0.665). A similar trend was observed for the monthly AP variability (p = 0.0311, R2 = 0.374). Average AP values did not differ between days with and without RAAA. However, during the three and seven days periods preceding RAAA AP variability parameters were greater and AP was rising.
Although these pressure differences are very small, higher AP values over longer periods of time as well as greater variability are associated with RAAA. The exact mechanism behind this association remains unclear. The postulation that low AP may precipitate RAAA based on the Laplace law should be discarded.
大气压力（AP）对腹主动脉瘤破裂（RAAA）发病的影响仍是一个未解之谜。我们通过分析最大系列的术中确诊RAAA病例，研究了RAAA的季节变化以及AP动态变化的影响。
为开展本研究，我们对546例RAAA患者进行了回顾性分析，这些患者于2003年1月1日至2012年12月31日期间在血管与血管内外科诊所CCS接受手术，手术时间在503天内。贝尔格莱德市的AP数据来自塞尔维亚共和国水文气象服务局出版的气象年鉴，测量地点为“贝尔格莱德天文台”水文气象站。仅纳入居住在贝尔格莱德扩展区域内、暴露于相似AP值的患者，以分析AP对RAAA的影响。
RAAA在冬季和秋季月份更为常见，但与其他季节相比无显著差异。AP值较高的月份与较高的RAAA发生率相关（p = 0.0008，R2 = 0.665）。月度AP变异性也观察到类似趋势（p = 0.0311，R2 = 0.374）。有RAAA和无RAAA的日子之间平均AP值无差异。然而，在RAAA发生前的三天和七天内，AP变异性参数更大且AP呈上升趋势。
尽管这些压力差异非常小，但较长时间内较高的AP值以及更大的变异性与RAAA相关。这种关联背后的确切机制仍不清楚。基于拉普拉斯定律认为低AP可能促使RAAA发生的假设应被摒弃。
