Wilmink A B, Quick C R
Institute of Public Health, University of Cambridge, UK.
Br J Surg. 1998 Feb;85(2):155-62. doi: 10.1046/j.1365-2168.1998.00714.x.
Ruptured abdominal aortic aneurysm (AAA) is a common cause of death which is preventable by elective repair of an asymptomatic AAA.
The literature was reviewed with emphasis on epidemiological studies and population-based screening surveys.
The prevalence of small AAA ranges between 3 and 8 per cent. The incidence of asymptomatic AAA seems to be increasing, although exact incidence estimates vary. The most important risk factors for AAA are male sex, age, family history and smoking. Hypertension is associated with a mildly increased risk, but diabetes is not associated with any increase. Primary prevention of AAA is not a realistic option. There is no evidence of an effective medical treatment to prevent growth of small AAAs, although trials with propranolol are under way. The only intervention to prevent death from aneurysm is elective repair of the asymptomatic lesion. Screening for asymptomatic AAA can reduce the incidence of rupture. However, further studies are needed to determine the cost effectiveness of screening compared with that of other health programmes.
腹主动脉瘤破裂是一种常见的可预防死因，可通过对无症状腹主动脉瘤进行择期修复来预防。
对文献进行综述，重点关注流行病学研究和基于人群的筛查调查。
小腹主动脉瘤的患病率在3%至8%之间。无症状腹主动脉瘤的发病率似乎在上升，尽管确切的发病率估计值有所不同。腹主动脉瘤最重要的危险因素是男性、年龄、家族史和吸烟。高血压与风险轻度增加有关，但糖尿病与风险增加无关。腹主动脉瘤的一级预防并非现实选择。尚无证据表明有有效的药物治疗可预防小腹主动脉瘤的生长，尽管普萘洛尔试验正在进行中。预防动脉瘤死亡的唯一干预措施是对无症状病变进行择期修复。筛查无症状腹主动脉瘤可降低破裂发生率。然而，需要进一步研究以确定筛查与其他健康项目相比的成本效益。
