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心血管高危患者腹主动脉瘤的患病率。

Prevalence of abdominal aortic aneurysm in patients with high cardiovascular risk.

作者信息

Cornejo Saucedo M A, García-Gil D, Brun Romero F M, Torres do Rego A, Beltrán Romero L, Rodilla Sala E, Acosta Guerra G, Villanueva Martínez J, Casas Rojo J M, Torres Macho J, García de Casasola-Sánchez G

机构信息

Unidad de Gestión Clínica Medicina Interna y Urgencias, Hospital San Carlos, San Fernando, Cádiz, España.

Unidad de Gestión Clínica Medicina Interna y Urgencias, Hospital San Carlos, San Fernando, Cádiz, España.

出版信息

Rev Clin Esp (Barc). 2018 Dec;218(9):461-467. doi: 10.1016/j.rce.2018.08.001. Epub 2018 Sep 20.

Abstract

BACKGROUND

To determine the prevalence of abdominal aortic aneurysm (AAA) (arterial diameter ≥30mm), in patients with high or very high cardiovascular risk (CVR) and to evaluate their clinical features.

PATIENTS AND METHODS

Observational, cross-sectional and multicentric study conducted in Spanish Internal Medicine Services. We enrolled men with age >55years and women >65years who had a high or very high CVR.

RESULTS

The study included 659 patients. The prevalence of AAA was 8% (53 patients). 76.9% were male with a mean age of 71±8.7years. The multivariate analysis showed an association between AAA and age (OR: 1.06; 95%CI: 1.02-1.1; P<.01), male sex (OR: 5.6; 95%CI: 1.6-18.8; P=.01), active smoking (OR: 3.22; 95%CI: 1.16-8.93; P=.024) and peripheral arterial disease (OR: 3.51; 95%CI: 1.73-7.09; P<.01). Diabetes mellitus was an independent protective factor (OR: 0.41; 95%CI: 0.22-0.78; P=.06). Those with subaneurysmal dilatation of the abdominal aorta (diameter 25-29.9mm) presented similar features as patients with AAA.

CONCLUSIONS

The prevalence of AAA in patients with high CVR is high. Ultrasound screening can be performed by general practitioners. Men >65years with elevated CVR could benefit, particularly in the presence of active smoking or peripheral arterial disease.

摘要

背景

确定心血管风险高或非常高的患者中腹主动脉瘤(AAA)(动脉直径≥30mm)的患病率,并评估其临床特征。

患者与方法

在西班牙内科服务机构进行的观察性、横断面和多中心研究。我们纳入了年龄>55岁的男性和>65岁的女性,他们具有高或非常高的心血管风险。

结果

该研究纳入了659名患者。腹主动脉瘤的患病率为8%(53例患者)。76.9%为男性,平均年龄为71±8.7岁。多变量分析显示腹主动脉瘤与年龄(比值比:1.06;95%置信区间:1.02-1.1;P<.01)、男性性别(比值比:5.6;95%置信区间:1.6-18.8;P=.01)、当前吸烟(比值比:3.22;95%置信区间:1.16-8.93;P=.024)和外周动脉疾病(比值比:3.51;95%置信区间:1.73-7.09;P<.01)之间存在关联。糖尿病是一个独立的保护因素(比值比:0.41;95%置信区间:0.22-0.78;P=.06)。腹主动脉瘤样扩张(直径25-29.9mm)的患者表现出与腹主动脉瘤患者相似的特征。

结论

心血管风险高的患者中腹主动脉瘤的患病率较高。全科医生可进行超声筛查。心血管风险升高的65岁以上男性可能会受益,特别是在存在当前吸烟或外周动脉疾病的情况下。

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