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基于人群的急性 A 型和 B 型主动脉夹层的稳定发病率。

Stable population-based incidence of acute type A and B aortic dissection.

机构信息

Department of Clinical Sciences, Lund University , Malmö , Sweden.

Vascular Center, Skåne University Hospital , Malmö , Sweden.

出版信息

Scand Cardiovasc J. 2019 Oct;53(5):274-279. doi: 10.1080/14017431.2019.1642509. Epub 2019 Jul 18.

Abstract

Aortic dissection (AD) and abdominal aortic aneurysm (AAA) share the same risk factors. Whereas the incidence of AAA is falling, it is unclear whether population-based incidences of acute type A and B AD have changed. The aim of this study was to investigate incidences of AD subtypes over time. . Citizens in the municipality of Malmö, Sweden, diagnosed with AD in 2000-2004 and 2014-2016 were identified through the in-patient, clinical, and forensic autopsy registers. . The overall and gender-specific incidences of acute type A and B AD were stable over time. The overall autopsy rate declined from 25.2% in 2000-2004 to 16.1% in 2014-2016 ( = .0001) and patients with acute type A AD were more often encountered at autopsy (78% of cases) during the first time period, compared to 43% of cases during the second time period ( = .005), when the ratio of acute type A: acute type B AD was 2.6: 1. The proportion of individuals <65 years of age tended to be higher in acute type A AD compared to acute type B AD ( = .07). The frequencies of hypertension and smoking were 90% and 91%, respectively, in type A AD, and 86% and 86%, respectively in type B AD. . Population-based incidences of acute type A and type B AD were stable over time, but the decreasing autopsy rate has led to a lower proportion of AD diagnosed at autopsy. Primary prevention towards hypertension and smoking seem necessary to reduce AD incidence.

摘要

主动脉夹层 (AD) 和腹主动脉瘤 (AAA) 具有相同的危险因素。虽然 AAA 的发病率正在下降,但尚不清楚急性 A 型和 B 型 AD 的人群发病率是否发生了变化。本研究旨在探讨 AD 亚型随时间的变化。

在瑞典马尔默市,通过住院、临床和法医尸检登记册,确定了 2000-2004 年和 2014-2016 年期间诊断为 AD 的患者。

急性 A 型和 B 型 AD 的总体和性别特异性发病率随时间保持稳定。总体尸检率从 2000-2004 年的 25.2%下降到 2014-2016 年的 16.1%( = .0001),并且在第一个时期,更多的急性 A 型 AD 患者在尸检中发现(78%的病例),而在第二个时期,只有 43%的病例在尸检中发现( = .005),此时急性 A 型:急性 B 型 AD 的比例为 2.6:1。与急性 B 型 AD 相比,65 岁以下人群中急性 A 型 AD 的比例较高( = .07)。A 型 AD 中高血压和吸烟的频率分别为 90%和 91%,B 型 AD 中高血压和吸烟的频率分别为 86%和 86%。

人群中急性 A 型和 B 型 AD 的发病率随时间保持稳定,但尸检率的下降导致尸检诊断 AD 的比例降低。针对高血压和吸烟的一级预防似乎对于降低 AD 的发病率是必要的。

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