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影响腹主动脉瘤生长速度的因素。对墨西哥队列的分析。

Factors that Influence Growth Rates of Abdominal Aortic Aneurysms. Analysis of a Mexican Cohort.

机构信息

Department of Vascular and Endovascular Surgery. Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Hospital Regional de Alta Especialidad de La Peninsula de Yucatan, Merida, Mexico.

出版信息

Vasc Endovascular Surg. 2024 Nov;58(8):813-817. doi: 10.1177/15385744241265758. Epub 2024 Jul 21.

Abstract

OBJECTIVE

Abdominal Aortic Aneurysms (AAA) growth remains a process not fully understood. The objective of this study was to analyze risk factors associated with changes in AAA diameter in a Mexican cohort.

METHODS

An observational study in which we analyzed the entirely of patients in which an AAA was reported in a Computed Tomography (CT) study from 2014 to 2021 who had a follow-up CT. We divided them by groups depending on the diagnosis of type 2 diabetic mellitus and pharmacological history (diabetic vs non-diabetic, metformin vs non-metformin intake and statin vs non-statin intake). We compared pre and post follow-up AAA diameters using paired t-tests. A multivariate analysis was performed in order to identify independent variables associated with an increased growth rate. Statistical analysis was performed on Stata 17.

RESULTS

During the studied period 72 (39.77%) patients had a follow-up CT. Mean age was 75 years (±9.05) and 52 (72.22%) were men. When comparing infra-renal largest diameter through time based on metformin intake, a significant difference was found only in the metformin non-intake group (42.05 ± 12.54 vs45.34 ± 12.06 [ = 0.02]), in contrast the metformin intake group measures were non-significantly different (36.13 ± 7.04 vs 37.00 ± 4.51; = 0.57) through follow-up. In the multivariate analysis AAA largest diameter at diagnosis correlated with significantly increased growth rate (coeff = 0.06, < 0.05).

CONCLUSIONS

AAA diameters appear to change through time in a non-linear pattern influenced by different epidemiological and clinical factors. Metformin intake appears to promote a stability in AAA diameter growth in our studied population.

摘要

目的

腹主动脉瘤(AAA)的生长仍然是一个尚未完全被理解的过程。本研究的目的是分析与墨西哥队列中 AAA 直径变化相关的危险因素。

方法

这是一项观察性研究,我们分析了 2014 年至 2021 年期间在计算机断层扫描(CT)研究中报告有 AAA 的所有患者的资料,这些患者均进行了随访 CT。我们根据 2 型糖尿病的诊断和药物治疗史(糖尿病与非糖尿病、二甲双胍与非二甲双胍摄入以及他汀类药物与非他汀类药物摄入)将他们分为不同的组。我们使用配对 t 检验比较了随访前后的 AAA 直径。为了确定与增长率增加相关的独立变量,我们进行了多变量分析。统计分析在 Stata 17 上进行。

结果

在研究期间,有 72 名(39.77%)患者进行了随访 CT。平均年龄为 75 岁(±9.05),其中 52 名(72.22%)为男性。当根据二甲双胍的摄入情况比较下腔静脉最宽直径随时间的变化时,仅在二甲双胍非摄入组中发现了显著差异(42.05 ± 12.54 与 45.34 ± 12.06 [ = 0.02]),而二甲双胍摄入组的测量值在随访过程中没有显著差异(36.13 ± 7.04 与 37.00 ± 4.51; = 0.57)。在多变量分析中,AAA 诊断时的最大直径与显著增加的增长率相关(系数=0.06, < 0.05)。

结论

AAA 直径似乎随时间呈非线性变化,受不同的流行病学和临床因素影响。在我们的研究人群中,二甲双胍的摄入似乎促进了 AAA 直径生长的稳定性。

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