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国际急性主动脉夹层注册研究的启示:20 年的协作临床研究经验。

Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research.

机构信息

Hospital General Universitari Vall d'Hebron, CIBER-CV, Barcelona, Spain (A.E.).

Massachusetts General Hospital, Boston (E.M.I.).

出版信息

Circulation. 2018 Apr 24;137(17):1846-1860. doi: 10.1161/CIRCULATIONAHA.117.031264.

Abstract

Acute aortic dissection (AAD) is a life-threatening condition associated with high morbidity and mortality rates, and it remains a challenge to diagnose and treat. The International Registry of Acute Aortic Dissection was established in 1996 with the mission to raise awareness of this condition and provide insights to guide diagnosis and treatment. Since then, >7300 cases have been included from >51 sites in 12 countries. Although presenting symptoms and physical findings have not changed significantly over this period, the use of computed tomography in the diagnosis has increased, and more patients are managed with interventional procedures: surgery in type A AAD and endovascular therapy in type B AAD; with these changes in care, there has been a significant decrease in overall in-hospital mortality in type A AAD but not in type B AAD. Herein, we summarized the key lessons learned from this international registry of patients with AAD over the past 20 years.

摘要

急性主动脉夹层(AAD)是一种危及生命的病症,其发病率和死亡率均较高,目前诊断和治疗仍具挑战性。国际急性主动脉夹层注册研究于 1996 年成立,旨在提高对此病症的认识,并提供相关见解以指导诊断和治疗。自那时以来,已经从 12 个国家的 51 个地点纳入了超过 7300 例病例。尽管在此期间,临床表现和体格检查并未发生显著变化,但在诊断中使用计算机断层扫描的情况有所增加,更多的患者接受介入治疗:A型 AAD 采用手术治疗,B 型 AAD 采用血管内治疗;随着治疗方式的改变,A型 AAD 的总体住院死亡率显著下降,但 B 型 AAD 则没有。在此,我们总结了过去 20 年来该国际 AAD 患者注册研究的主要经验教训。

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