人口ベースのスクリーニングプログラムにおける大動脈直径の減少と下大動脈動脈瘤の流行の減少
Antti Siika1, Anton Axelsson1, Nina Fattahi1,2
1Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.
The British journal of surgery
|August 20, 2025
まとめ
腹動脈動脈瘤 (AAA) の罹患率は65歳の男性に減少したが,小動脈は死亡リスクを増加させた. 禁煙はAAAの進行と死亡率を大幅に減少させる.
科学分野:
- 血管 外科
- エピデミオロジー
- 公衆衛生
背景:
- 人口ベースの腹動脈動脈瘤 (AAA) のスクリーニングプログラムの中で,下大動脈の直径と死亡率との関連を調査した.
- 14年間のAAA患者のリスク因子の分布と結果の変化を分析した.
研究 の 目的:
- 大動脈直径の時間的な傾向と 長期の死亡率との関連をスクリーニングプログラムで調べる
- AAAを患った人のリスク要因と結果の変化を分析する.
主な方法:
- 2010年から2023年にかけての集団ベースのコホート研究で,AAAスクリーニングに招待された152,000人の65歳男性が含まれています.
- 地域スクリーニングデータベースから大動脈直径と死亡率のデータを抽出しました.
主要な成果:
- 117,120人の男性を検査し,平均大動脈直径の減少とAAAの流行を観察した.
- 初期大動脈直径と死亡率との非線形関連が発見され,5年後の死亡率は大動脈の大きさに伴い増加した.
- 禁煙は手術の遅延と5年後の死亡率の減少と関連していた (現在の喫煙者では5. 6% vs 11. 1%).
結論:
- 小動脈動脈と小動脈動脈の有病率は低下し,小動脈動脈の有病率はわずかに増加した.
- 小型または動脈動脈動脈を持つ男性は,直径が正常な男性に比べて5年後に死亡するリスクが1.5~2.5倍高い.
- 禁煙はAAAの進行を停止し,死亡率の低下と関連しています.
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