本文選題：他汀類藥物　切入點(diǎn)：主動脈夾層　出處：《中國實(shí)用內(nèi)科雜志》2017年07期 　論文類型：期刊論文

【摘要】：目的觀察他汀類藥物對Stanford B型主動脈夾層患者行主動脈腔內(nèi)修復(fù)術(shù)療效的影響。方法回顧性分析2002年4月至2013年10月于沈陽軍區(qū)總醫(yī)院心血管內(nèi)科住院治療并行主動脈腔內(nèi)修復(fù)術(shù)治療的Stanford B型主動脈夾層患者388例,分析他汀組與非他汀組臨床特點(diǎn)及主動脈腔內(nèi)修復(fù)術(shù)后圍手術(shù)期及3年隨訪的死亡率、再次行主動脈腔內(nèi)修復(fù)術(shù)等事件的發(fā)生率。結(jié)果 (1)兩組患者臨床資料比較:兩組患者的性別、年齡及體重指數(shù)等無統(tǒng)計(jì)學(xué)意義(P均0.05);他汀組與非他汀組患糖尿病、腦卒中的比例無統(tǒng)計(jì)學(xué)意義(P均0.05);他汀組高血壓病、冠心病的比例明顯高于非他汀組(P均0.05);他汀組服用阿司匹林腸溶片的比例明顯高于非他汀組(P0.001);兩組患者伴胸腔積液、心包積液的比例無統(tǒng)計(jì)學(xué)差異(P均0.05)。(2)圍手術(shù)期情況:兩組患者植入支架的數(shù)目、長度、近遠(yuǎn)端直徑及內(nèi)漏的發(fā)生等差異均無統(tǒng)計(jì)學(xué)意義(P均0.05);非他汀組完全封閉左鎖骨下動脈的比例明顯高于他汀組(P=0.020);兩組患者圍術(shù)期死亡、術(shù)后發(fā)熱、腦卒中、肢體活動障礙及住院時(shí)間等差異均無統(tǒng)計(jì)學(xué)差異(P均0.05);他汀組合并PCI的比例明顯高于非他汀組(P0.001)。(3)隨訪時(shí)間36個(gè)月,隨訪率為79.5%。隨訪期間兩組患者死亡率、再次行主動脈腔內(nèi)修復(fù)術(shù)、新發(fā)冠心病、腦卒中、截癱等均無統(tǒng)計(jì)學(xué)差異(P均0.05)。結(jié)論單中心研究未顯示他汀類藥物可以改善主動脈夾層患者行主動脈腔內(nèi)修復(fù)術(shù)的近遠(yuǎn)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.
【作者單位】： 沈陽軍區(qū)總醫(yī)院心內(nèi)科;
【基金】：遼寧省科技計(jì)劃項(xiàng)目(2012225009)
【分類號】：R543.1

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本文編號：1591034