Department of Vascular Surgery, Changhai Hospital, Second Military Medical University, Shanghai, 200433, China.
Department of Breast and Thyroid Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China.
Sci Rep. 2018 Jan 19;8(1):1215. doi: 10.1038/s41598-018-19691-6.
Partial thrombosis of the false lumen in uncomplicated type B aortic dissection (uTBAD) is associated with an increased late mortality risk. Whether the serum cortisol level can affect false lumen thrombosis in patients with uTBAD has not been well characterized. This study was performed on 87 patients with uTBAD. A curve-fitting method was used to analyze the relationship between serum cortisol and partial thrombosis of false lumen. Univariate and multivariate logistic regression analyses were used to identify false lumen partial thrombosis-associated serum cortisol. Curve-fitting's result revealed a characteristic U shape, and 14.0 µg/dL was considered as the cutoff point for serum cortisol. The results of univariate and multivariate logistic regression analyses suggested that when trisecting the serum cortisol level into three parts, the low and high levels of serum cortisol could significantly affect the occurrence of false lumen partial thrombosis compared with the middle level. The odds ratio value of the low and high levels of serum cortisol was 6.12 and 4.65, respectively, in the univariate analysis, and 24.32 and 3.93, respectively, in the multivariate analysis. Low or high levels of serum cortisol might influence the natural result of uTBAD through affecting the false lumen thrombosis.
未复杂性 B 型主动脉夹层(uTBAD)的假腔部分血栓形成与晚期死亡率增加相关。血清皮质醇水平是否会影响 uTBAD 患者的假腔血栓形成尚未得到充分描述。本研究纳入了 87 例 uTBAD 患者。采用曲线拟合方法分析血清皮质醇与假腔部分血栓形成之间的关系。采用单因素和多因素逻辑回归分析鉴定与假腔部分血栓形成相关的血清皮质醇。曲线拟合结果显示出特征性的 U 形,将血清皮质醇水平 14.0μg/dL 作为截断点。单因素和多因素逻辑回归分析结果表明,将血清皮质醇水平三等分后,与中间水平相比,低和高水平的血清皮质醇均显著影响假腔部分血栓形成的发生。低和高水平血清皮质醇的比值比在单因素分析中分别为 6.12 和 4.65,在多因素分析中分别为 24.32 和 3.93。低或高水平的血清皮质醇可能通过影响假腔血栓形成来影响 uTBAD 的自然病程。