Erbel R
Institut für Medizinische Informatik, Biometrie und Epidemiologie, Universitätsklinikum Essen, Universität Duisburg-Essen, Hufelandstr. 55, 45147, Essen, Deutschland.
Herz. 2018 May;43(3):275-290. doi: 10.1007/s00059-018-4694-2.
Aortic diseases include not only the thoracic but also the abdominal part of the aorta. In the etiology cardiovascular risk factors, such as hypertension, smoking and hyperlipoproteinemia play a major role, but more and more genetic diseases with familiar predisposition are being identified. Even large aneurysms remain asymptomatic as long as other organs in the neighborhood are not damaged and no acute aortic event occurs including aortic dissection, intramural hematoma, penetrating aortic ulcer, and traumatic aortic injury. Standardized algorithms allow precise and rapid diagnosis for initiating medicinal therapy or operative and/or endovascular interventions (thoracic/endovascular aortic repair, TEVAR/EVAR) in this emergency situation. Specialized aortic centers are recommended to form localized regional networks.
主动脉疾病不仅包括胸主动脉,还包括腹主动脉。在病因方面,心血管危险因素,如高血压、吸烟和高脂蛋白血症起主要作用,但越来越多具有家族易感性的遗传疾病也被发现。只要附近的其他器官未受损且未发生急性主动脉事件,包括主动脉夹层、壁内血肿、穿透性主动脉溃疡和创伤性主动脉损伤,即使是大动脉瘤也可能无症状。标准化算法可在这种紧急情况下实现精确快速诊断,以便启动药物治疗或进行手术和/或血管内介入治疗(胸主动脉/血管内主动脉修复术,TEVAR/EVAR)。建议专门的主动脉中心形成局部区域网络。