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目的:通过对64例主动脉夹层患者的临床特点分析,探讨伴有高血压史患者主动脉夹层的临床特点及治疗情况。方法:患者收住入院后行心脏B超或／和CT或／和MRI明确诊断和分型,进行生命体征监护,观察首发症状,入院时血压及治疗情况。结果:1．有高血压和无高血压主动脉夹层患者在年龄、性别、主动脉夹层分型及有无首发症状等方面无显著性差异P>0．05;2．主动脉夹层患者中高血压患者明显高于非高血压患者(40／24);3．有高血压和无高血压主动脉夹层患者入院时血压水平存在显著性差异P<0．05。结论:高血压与主动脉夹层密切相关,是其主要病因之一,有高血压的夹层患者入院时的收缩压、舒张压和脉压差均高于无高血压的夹层患者且具有统计学意义。在主动脉夹层发生的年龄、性别、夹层分型及初始症状方面两者无显著性差异。经内科治疗大部分患者病情可缓解稳定,但却不能治愈主动脉夹层。主动脉内支架植入术对破口较大或多个破口的B型患者安全性及治愈率均较高,A型患者可予以外科血管置换术治疗。
Objective: To analyze the clinical features of 64 patients with aortic dissection to explore the clinical features and treatment of aortic dissection with history of hypertension. Methods: The patients were admitted to hospital after cardiac B-or / and CT or / and MRI to confirm the diagnosis and classification, the monitoring of vital signs, observation of the first symptom, admission blood pressure and treatment. Results: 1. Patients with hypertension and hypertension without aortic dissection in age, gender, aortic dissection and the presence or absence of the first symptom, etc. no significant difference (P> 0.05); In hypertensive patients with aortic dissection was significantly higher than non-hypertensive patients (40/24); 3. There was a significant difference in blood pressure levels at hospital admission between hypertensive and non-hypertensive patients with aortic dissection (P <0.05). Conclusions: Hypertension is closely related to aorta dissection, which is one of the major causes. The systolic blood pressure, diastolic blood pressure and pulse pressure difference at admission were significantly higher in hypertensive disseminated patients than those without hypertensive dissection . There was no significant difference in the age, sex, type of dissection and initial symptoms of aortic dissection between the two groups. The medical treatment of most patients can ease the disease condition, but can not cure aortic dissection. Aortic stent implantation in breach of a larger or more break in type B patients with higher safety and cure rates, type A patients may be treated with surgical vascular replacement.