他汀类药物对Stanford B型主动脉夹层患者主动脉腔内修复术疗效的影响

发布时间：2018-03-10 01:00

本文选题：他汀类药物　切入点：主动脉夹层　出处：《中国实用内科杂志》2017年07期 　论文类型：期刊论文

【摘要】：目的观察他汀类药物对Stanford B型主动脉夹层患者行主动脉腔内修复术疗效的影响。方法回顾性分析2002年4月至2013年10月于沈阳军区总医院心血管内科住院治疗并行主动脉腔内修复术治疗的Stanford B型主动脉夹层患者388例,分析他汀组与非他汀组临床特点及主动脉腔内修复术后围手术期及3年随访的死亡率、再次行主动脉腔内修复术等事件的发生率。结果 (1)两组患者临床资料比较:两组患者的性别、年龄及体重指数等无统计学意义(P均0.05);他汀组与非他汀组患糖尿病、脑卒中的比例无统计学意义(P均0.05);他汀组高血压病、冠心病的比例明显高于非他汀组(P均0.05);他汀组服用阿司匹林肠溶片的比例明显高于非他汀组(P0.001);两组患者伴胸腔积液、心包积液的比例无统计学差异(P均0.05)。(2)围手术期情况:两组患者植入支架的数目、长度、近远端直径及内漏的发生等差异均无统计学意义(P均0.05);非他汀组完全封闭左锁骨下动脉的比例明显高于他汀组(P=0.020);两组患者围术期死亡、术后发热、脑卒中、肢体活动障碍及住院时间等差异均无统计学差异(P均0.05);他汀组合并PCI的比例明显高于非他汀组(P0.001)。(3)随访时间36个月,随访率为79.5%。随访期间两组患者死亡率、再次行主动脉腔内修复术、新发冠心病、脑卒中、截瘫等均无统计学差异(P均0.05)。结论单中心研究未显示他汀类药物可以改善主动脉夹层患者行主动脉腔内修复术的近远期生存率。
[Abstract]:Objective to observe the effect of statins on endovascular aortic repair in patients with Stanford type B aortic dissection. Methods from April 2002 to October 2013, we retrospectively analyzed the effect of statin on the treatment of Stanford B aortic dissection. Methods from April 2002 to October 2013, the patients were hospitalized in the Department of Cardiovascular Medicine, Shenyang military region General Hospital. There were 388 patients with Stanford B aortic dissection treated by endovascular aortic repair. To analyze the clinical characteristics of statin group and non-statin group and the mortality of perioperative period and 3-year follow-up after endovascular aortic repair. Results: there were no significant differences in sex, age and body mass index between the two groups, and there was no significant difference in sex, age and body mass index between the two groups (P > 0.05). The proportion of stroke was not statistically significant (P = 0.05); the proportion of coronary heart disease in statins group was significantly higher than that in non-statins group (P < 0.05); the proportion of aspirin enteric-coated tablets in statins group was significantly higher than that in non-statin group (P 0.001); the patients in both groups had pleural effusion. Perioperative period: the number and length of stents implanted in the two groups; There was no significant difference in diameter of proximal distal end and occurrence of internal leakage (P < 0.05), the proportion of left subclavian artery closed completely in non-statin group was significantly higher than that in statin group (P 0.020), perioperative death, postoperative fever and stroke in both groups. There was no significant difference in limb movement disorder and hospitalization time (P < 0.05); the proportion of statins combined with PCI was significantly higher than that of non-statin group (P 0.001) for 36 months, and the follow-up rate was 79.5%. During the follow-up period, the mortality of the two groups was 79.5%. Another endovascular repair of aorta, new coronary heart disease, stroke, Conclusion the single center study does not show that statins can improve the short-term and long-term survival rate of aortic dissection patients undergoing endovascular aortic repair.
【作者单位】：沈阳军区总医院心内科;
【基金】：辽宁省科技计划项目(2012225009)
【分类号】：R543.1

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