Bickerstaff L K, Pairolero P C, Hollier L H, Melton L J, Van Peenen H J, Cherry K J, Joyce J W, Lie J T
Surgery. 1982 Dec;92(6):1103-8.
Thoracic aortic aneurysms were detected in 72 residents (44 women and 28 men) in a stable midwestern community over a 30-year period, for an age- and sex-adjusted incidence of 5.9 new aneurysms per 100,000 person-years. The incidence was equal in both sexes and decreased slightly over the 30 years. Ages ranged from 47 to 93 years (median 65 years for men and 77 years for women). The ascending aorta was involved in 37 patients, the aortic arch in 8, and the descending aorta in 27. Pathologic examination was performed in 51 patients. The cause was aortic dissection in 27 patients (53%), atherosclerosis in 15 (29%), aortitis in 4 (8%), cystic medial necrosis in 3 (6%), and syphilis in 2 (4%). All autopsied patients had pathologic evidence of significant hypertension. Eleven patients (25%) had concomitant abdominal aortic aneurysms. Rupture occurred in 53 patients (74%) and 50 died. Thirty-seven of these patients had no prior diagnosis of aneurysm. The median interval between diagnosis and rupture in the 16 remaining patients was 2 years (range 1 month to 16 years). Ninety-five percent of aortic dissections ruptured and 51% of nondissecting aneurysms ruptured. The actuarial 5-year survival for all 72 patients was 13%; for patients with aortic dissection, 7% and for patients without dissection, 19.2%.
在一个稳定的中西部社区，30年间共检测到72例胸主动脉瘤患者（44名女性和28名男性），年龄和性别调整后的发病率为每10万人年5.9例新发病例。男女发病率相等，且在30年间略有下降。年龄范围为47至93岁（男性中位数为65岁，女性为77岁）。升主动脉受累37例，主动脉弓受累8例，降主动脉受累27例。51例患者进行了病理检查。病因包括主动脉夹层27例（53%）、动脉粥样硬化15例（29%）、主动脉炎4例（8%）、囊性中膜坏死3例（6%）、梅毒2例（4%）。所有尸检患者均有明显高血压的病理证据。11例患者（25%）合并腹主动脉瘤。53例患者（74%）发生破裂，50例死亡。其中37例患者此前未诊断出动脉瘤。其余16例患者诊断至破裂的中位间隔时间为2年（范围1个月至16年）。95%的主动脉夹层破裂，51%的非夹层动脉瘤破裂。72例患者的5年精算生存率为13%；主动脉夹层患者为7%，非夹层患者为19.2%。
