Körfer Daniel, Grond-Ginsbach Caspar, Hakimi Maani, Böckler Dittmar, Erhart Philipp
Department of Vascular and Endovascular Surgery, Heidelberg University Hospital, 69120 Heidelberg, Germany.
Department of Vascular Surgery, Lucerne Cantonal Hospital, 6000 Lucerne, Switzerland.
J Clin Med. 2022 Apr 27;11(9):2450. doi: 10.3390/jcm11092450.
The aim of this study was to investigate sex-dependent aneurysm distributions. A total of 3107 patients with arterial aneurysms were diagnosed from 2006 to 2016. Patients with anything other than true aneurysms, hereditary connective tissue disorders or vasculitides (n = 918) were excluded. Affected arterial sites and age at first aneurysm diagnosis were compared between women and men by an unpaired two-tailed t-test and Fisher’s exact test. The study sample consisted of 2189 patients, of whom 1873 were men (85.6%) and 316 women (14.4%) (ratio m:w = 5.9:1). Men had considerably more aneurysms in the abdominal aorta (83.4% vs. 71.1%; p < 0.001), common iliac artery (28.7% vs. 8.9%; p < 0.001), internal iliac artery (6.6% vs. 1.3%; p < 0.001) and popliteal artery (11.1% vs. 2.5%; p < 0.001). In contrast, women had a higher proportion of aneurysms in the ascending aorta (4.4% vs. 10.8%; p < 0.001), descending aorta (11.1% vs. 36.4%; p < 0.001), splenic artery (0.9% vs. 5.1%; p < 0.001) and renal artery (0.8% vs. 6.0%; p < 0.001). Age at disease onset and further aneurysm distribution showed no considerable difference. The infrarenal segment might be considered a natural border for aneurysm formation in men and women suspected to have distinct genetic, pathophysiologic and ontogenetic factors. Screening modalities for women at risk might need further adjustment, particularly thoracic cross-sectional imaging complementation.
本研究的目的是调查动脉瘤分布的性别差异。2006年至2016年期间，共诊断出3107例动脉动脉瘤患者。排除真性动脉瘤以外的任何疾病、遗传性结缔组织疾病或血管炎患者（n = 918）。采用非配对双尾t检验和Fisher精确检验比较女性和男性首次诊断动脉瘤时的受累动脉部位和年龄。研究样本包括2189例患者，其中男性1873例（85.6%），女性316例（14.4%）（男:女比例= 5.9:1）。男性腹主动脉瘤（83.4%对71.1%；p < 0.001）、髂总动脉（28.7%对8.9%；p < 0.001）、髂内动脉（6.6%对1.3%；p < 0.001）和腘动脉（11.1%对2.5%；p < 0.001）的动脉瘤明显更多。相比之下，女性升主动脉（4.4%对10.8%；p < 0.001）、降主动脉（11.1%对36.4%；p < 0.001）、脾动脉（0.9%对5.1%；p < 0.001）和肾动脉（0.8%对6.0%；p < 0.001）的动脉瘤比例更高。发病年龄和进一步的动脉瘤分布没有显著差异。肾下段可能被认为是男性和女性动脉瘤形成的自然边界，怀疑存在不同的遗传、病理生理和个体发育因素。对高危女性的筛查方式可能需要进一步调整，特别是胸部横断面成像补充检查。
