摘要
目的分析急性A型主动脉夹层术前低氧血症的临床相关因素。方法2011年1月至6月，随机采集54例急性A型主动脉夹层患者临床资料。男42例，女12例；年龄28—73岁；发病到就诊时间0．4～14．0天。收集患者年龄、性别、发病时间、体重指数、高血压史、糖尿病史、吸烟史、饮酒史、心脏射血分数、凝血酶原时间、纤维蛋白原定量、纤维蛋白原降解产物、D-二聚体定量、C-反应蛋白、降钙素原测定结果、ICU时间和住院时间。低氧血症定义为静态未吸氧情况下，氧分压（PaO：）〈（100-年龄×0．33±5）mmHg（1mmHg=0．133kPa）。结果患者中无低氧血症组14例，其中2例未手术者死亡，手术12例无死亡；低氧血症组40例，其中7例未手术者均死亡，手术33例，死亡2例。两组患者年龄、性别、发病时间、高血压史、糖尿病史、吸烟史、饮酒史、心脏射血分数、凝血酶原时间和纤维蛋白原定量差异无统计学意义，P〉0．05；体重指数、纤维蛋白原降解产物、D-二聚体定量、C-反应蛋白、钙素原测定、ICU停留时间和住院时间差异有统计学意义，P〈0．05。结论急性A型主动脉夹层患者术前伴有低氧血症与肥胖、凝血纤维溶解系统被激活和炎症反应过度有关。
Objective Analyze preoperative clinical relevanted factors of acute type A aortic dissection with hypoxemia according to a group clinical data. Methods From January 2011 to June 2011, we have collected 54 preoperative cases of a- cute type A aortic dissection, including 42 males, 12 females, aged 28 -73 years old, onset to treatment time is 0.4 - 14.0 days. General information： age, gender, time of onset, body mass index, hypertension, diabetes mellitus, smoking, drinking, heart ejection fraction, prothrombin time, quantitative fibrinogen, fibrinogen degradation products, D-dimer, C-reactive pro- tein, procalcitonin, ICU time, length of hospital stay. According to the blood gas analysis of quiet state case without oxygen, with PaO2 〈 （ 100 - age × 0.33± 5 ） mm Hg is for the hypoxemia group, equal or higher than this is no-hypoxemia group. Resuits No-hypoxemia group has 14 cases, 11 males, 3 females, average aged （51.14 ± 14.24） years old, including 12 operation patients（ no death） and 2 no-operation patients（2 cases death）. Hypoxemia group has 40 cases, 31 males, 9 females, av- erage aged （50.53 ± 9.73 ） years old, including 33 operation patients （ 2 cases death ） and 7 no-operation patients （ 7 cases death）. There is no significant difference in age, gender, time of onset, hypertension, diabetes mellitus, smoking, drinking , cardiac ejection fraction, prothrombin time and fibrinogen. There is statistically significant on body mass index, fibrinogen deg- radation products, D-dimer, C-reactive protein , procalcitonin, ICU time and length of hospital stay time（ P 〈 0.05 ）. Conclu- sion Preoperative hypoxemia with acute type A aortic dissection is associated with obesity, excessive inflammation and activa- tion of coagulation and fibrinolytic system, and hypoxemia may prolong the time of operative patients with acute type A aortic dissection in ICU and hospital.
出处
《中华胸心血管外科杂志》
CSCD
北大核心
2012年第3期149-151,共3页
Chinese Journal of Thoracic and Cardiovascular Surgery
基金
首都医学科研发展基金（2007-2017）,北京市教育委员会科技计划重点项目（KZ201010025017）,国家自然科学基金（30972868）,首都医科大学基础-临床科研合作基金（11021202）
