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主动脉疾病的医学管理:如果他们不需要手术,他们需要什么?

Medical Management of Aortic Disease: If They Don't Need Surgery, What Do They Need?

机构信息

Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas, US.

出版信息

Methodist Debakey Cardiovasc J. 2023 Mar 7;19(2):70-77. doi: 10.14797/mdcvj.1192. eCollection 2023.

DOI:10.14797/mdcvj.1192
PMID:36910548
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10000319/
Abstract

Management of aortic disease has evolved significantly over the past few decades. A preemptive diagnostic approach with a multidisciplinary team and shared decision-making has led to improved clinical outcomes. Surgery is the cornerstone of management for most aortic conditions; however, medical therapy is now an important adjunctive therapy in most if not all patients. Herein, we review the role and evidence behind medical management of patients with aortic disease.

摘要

在过去的几十年中,主动脉疾病的管理发生了重大变化。多学科团队的预防性诊断方法和共同决策导致了临床结果的改善。手术是大多数主动脉疾病管理的基石;然而,药物治疗现在是大多数(如果不是全部)患者的重要辅助治疗。本文回顾了主动脉疾病患者药物治疗的作用和证据。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/10000319/f0a3b301714b/mdcvj-19-2-1192-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/10000319/9036ef3e7a1d/mdcvj-19-2-1192-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/10000319/f0a3b301714b/mdcvj-19-2-1192-g2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/10000319/9036ef3e7a1d/mdcvj-19-2-1192-g1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0907/10000319/f0a3b301714b/mdcvj-19-2-1192-g2.jpg

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本文引用的文献

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False Lumen Flow Assessment by Magnetic Resonance Imaging and Long-Term Outcomes in Uncomplicated Aortic Dissection.磁共振成像评估假腔血流与非复杂性主动脉夹层的长期预后。
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Meta-analysis suggests statins reduce mortality after abdominal aortic aneurysm repair.
荟萃分析表明,他汀类药物可降低腹主动脉瘤修复术后的死亡率。
J Vasc Surg. 2022 Jan;75(1):356-362.e4. doi: 10.1016/j.jvs.2021.06.033. Epub 2021 Jun 28.
4
Preoperative statin therapy is associated with higher 5-year survival after thoracic endovascular aortic repair.术前他汀类药物治疗与胸主动脉腔内修复术后 5 年生存率的提高有关。
J Vasc Surg. 2021 Dec;74(6):1996-2005. doi: 10.1016/j.jvs.2021.05.057. Epub 2021 Jun 26.
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Medical or endovascular management of acute type B aortic dissection.急性B型主动脉夹层的药物或血管内治疗
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Association of Long-term Use of Antihypertensive Medications With Late Outcomes Among Patients With Aortic Dissection.长期使用抗高血压药物与主动脉夹层患者晚期结局的关系。
JAMA Netw Open. 2021 Mar 1;4(3):e210469. doi: 10.1001/jamanetworkopen.2021.0469.
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Celiprolol Treatment in Patients with Vascular Ehlers-Danlos Syndrome.西洛他唑治疗血管型埃勒斯-当洛斯综合征。
Eur J Vasc Endovasc Surg. 2021 Feb;61(2):326-331. doi: 10.1016/j.ejvs.2020.10.020. Epub 2020 Nov 20.
8
Association of Fluoroquinolones With the Risk of Aortic Aneurysm or Aortic Dissection.氟喹诺酮类药物与主动脉瘤或主动脉夹层风险的关联。
JAMA Intern Med. 2020 Dec 1;180(12):1596-1605. doi: 10.1001/jamainternmed.2020.4199.
9
Meta-analysis Examining the Usefulness of Angiotensin Receptor blockers for the Prevention of Aortic Root Dilation in Patients With the Marfan Syndrome.Meta 分析研究血管紧张素受体阻滞剂在马凡综合征患者预防主动脉根部扩张中的作用。
Am J Cardiol. 2020 Aug 1;128:101-106. doi: 10.1016/j.amjcard.2020.04.034. Epub 2020 May 19.
10
Irbesartan in Marfan syndrome (AIMS): a double-blind, placebo-controlled randomised trial.马凡综合征中应用厄贝沙坦(AIMS):一项双盲、安慰剂对照随机试验。
Lancet. 2019 Dec 21;394(10216):2263-2270. doi: 10.1016/S0140-6736(19)32518-8. Epub 2019 Dec 10.