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目的探讨以下肢缺血为主要临床表现的急性主动脉夹层的临床特点及影响因素。方法选取该院2015年1月—2017年1月接收的诊断为急性主动脉夹层的80例患者作为研究对象,其中以下肢缺血为主的急性主动脉夹层12例为观察组,其他为非下肢缺血为主的68例急性主动脉夹层患者为对照组,对比其临床特点,分析其影响因素。结果观察组患者的背痛、腹痛、肠系膜缺血、Standford A型以及血D-二聚体水平显著区别于对照组,差异有统计学意义(P<0.05)。采用多因素非条件Logistic回归分析以下肢缺血为主的急性主动脉夹层的影响因素为背痛、Standford A型以及血D-二聚体水平。结论以下肢缺血为主的急性主动脉夹层患者在临床上较为常见,临床上容易误诊,患者血D-二聚体水平较高,背痛明显,最常见的是Standford A型。
Objective To investigate the clinical characteristics and influencing factors of acute aortic dissection with the following clinical manifestations. Methods A total of 80 patients diagnosed as acute aortic dissection from January 2015 to January 2017 in our hospital were selected as the research object. Among them, 12 cases of acute aortic dissection with the lower limb ischemia were the observation group and the others were non- The 68 cases of acute aortic dissection with ischemia in the lower limbs were the control group. The clinical characteristics were compared and the influencing factors were analyzed. Results The patients in the observation group had significant differences in back pain, abdominal pain, mesenteric ischemia, Standford A type and blood D-dimer level compared with the control group (P <0.05). Multivariate non-conditional logistic regression analysis was used to analyze the factors affecting the severity of lower limb ischemia in acute aortic dissection, such as back pain, Standford A type and blood D-dimer level. Conclusion Acute aortic dissection with lower extremity ischemia is more common in clinical practice. It is easily misdiagnosed in clinic. The level of D-dimer in blood is high and the back pain is obvious. Standford type A is the most common type.