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在NAAASP的监测下,小和中等腹动脉动脉瘤的男性的安全性
Clare Oliver-Williams1,2, Michael J Sweeting1,3, Jo Jacomelli4
1Cardiovascular Epidemiology Unit, Department of Public Health & Primary Care, University of Cambridge, UK (C.O.-W., M.S.).
Circulation
|January 15, 2019
概括
对于腹腔大动脉瘤 (AAA) 进行监测的男性,破裂的风险较低. 密集的监测确保了中小AAA患者的安全,无需改变目前的5. 5厘米转移值.
科学领域:
- 血管外科
- 公共卫生查
- 流行病学
背景情况:
- 人口查腹腔大动脉瘤 (AAA) 降低死亡率高达50%.
- 大多数阳性查结果的男性的AAA小于5. 5厘米的治疗值,并进入监测.
- 这项研究评估了接受AAA监测的男性的破裂风险.
研究的目的:
- 在超声监测下的男性中确定破裂AAA (rAAA) 的风险
- 评估目前对查检测到的AAA的监测协议的安全性.
- 评估AAA治疗的5.5厘米转移值是否合适.
主要方法:
- 在国家卫生服务AAA查计划中的男性的随访小 (3-4.4厘米) 或中等 (4.5-5.4厘米) AAA.
- 从查数据库收集AAA直径,转诊日期和随访损失的数据.
- 根据初始和最终AAA直径计算破裂和死亡率.
主要成果:
- 对18,652名男性进行了50,103人年的随访,其中31人经历了rAAA (29人死亡).
- 总体死亡率为每年1.96%,主要原因是心血管疾病和癌症.
- 年度rAAA风险为小AAA的0. 03%和中等AAA的0. 28%,在5. 5厘米门附近升至0. 40%.
结论:
- 在监测期间,rAAA的年风险低于0. 5%,即使在AAA略低于5. 5厘米的转诊值.
- 检测到中小AAA的男性在密集监测下是安全的.
- 目前的证据不支持改变AAA治疗的5. 5厘米转诊值.
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