Ogren M, Bengtsson H, Bergqvist D, Ekberg O, Hedblad B, Janzon L
Department of Community Health Sciences, Lund University, Malmö General Hospital, Sweden.
Eur J Vasc Endovasc Surg. 1996 Jan;11(1):42-7. doi: 10.1016/s1078-5884(96)80133-x.
To study the natural course of screening-detected symptomless abdominal aortic aneurysm (AAA) in elderly men.
Malmö, a city in southern Sweden with 230,000 inhabitants and a single referral hospital.
423 seventy-four-year-old men, randomly selected from the population and belonging to the prospective population study "Men born in 1914", were invited. 343 underwent AAA screening, whereas 80 declined or had moved.
Five year all cause mortality in relation to participation in and findings at ultrasound screening for AAA.
An abdominal aortic aneurysm was present in 38 (11%) out of 340 men who underwent screening and who had a native aorta. During 5 years of follow-up, one third (13/38) of these men died; 7 from myocardial infarction and 3 from stroke. The mortality rate in men with AAA was 80.2/1000 person years; twice as high as it was in men without AAA (39.4/1000 person years; p = 0.018). Six men underwent AAA surgery. None of them died from aneurysm rupture. However, aneurysm surgery did not reduce the total mortality rate in these men. The highest mortality rate, 91.9/1000 person years, was found in the men who did not participate in the screening.
It is our conclusion that screening for early detection and intervention is of questionable value from a public health perspective.
研究老年男性筛查发现的无症状腹主动脉瘤（AAA）的自然病程。
瑞典南部城市马尔默，有23万居民，且只有一家转诊医院。
从“1914年出生的男性”这项前瞻性人群研究中随机选取423名74岁男性并邀请其参与。343人接受了AAA筛查，80人拒绝或已搬走。
与参与AAA超声筛查及筛查结果相关的五年全因死亡率。
在340名接受筛查且有正常主动脉的男性中，38人（11%）存在腹主动脉瘤。在5年随访期间，这些男性中有三分之一（13/38）死亡；7人死于心肌梗死，3人死于中风。AAA男性的死亡率为80.2/1000人年；是无AAA男性死亡率（39.4/1000人年；p = 0.018）的两倍。6名男性接受了AAA手术。他们均未死于动脉瘤破裂。然而，动脉瘤手术并未降低这些男性的总死亡率。未参与筛查的男性死亡率最高，为91.9/1000人年。
我们的结论是，从公共卫生角度来看，进行早期检测和干预的筛查价值存疑。
