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在急性A型大动脉剖析患者中,孤立的左脊椎动脉的预后值
Luqin Yan1, Changying Zhao1, Dongzhu Duojie2
1Department of Cardiovascular Surgery, First Affiliated Hospital of Xi'an Jiaotong University, No. 277 Yanta West Road, Xi'an, 710061, Shaanxi, China.
BMC cardiovascular disorders
|January 7, 2026
概括
患有急性A型大动脉剖析和孤立的左脊动脉 (ILVA) 的患者面临更高的长期风险,主要的不良心血管和脑血管事件 (MACCE). ILVA是这些长期结果的重要风险因素.
科学领域:
- 心血管外科心血管外科
- 血管外科 血管外科
- 主动脉疾病 主动脉疾病
背景情况:
- 急性A型大动脉解剖 (ATAAD) 具有重大风险,特别是在左脊椎动脉隔离 (ILVA) 患者中.
- 在ATAAD患者中,ILVA与术后脑损伤风险增加有关.
- 对于具有ILVA的ATAAD患者的长期预后需要进一步调查.
研究的目的:
- 为了评估与ILVA的ATAAD患者的长期预后.
- 确定与ILVA.ATAAD患者不良结果相关的风险因素.
主要方法:
- 追溯队列研究比较了具有和没有ILVA的ATAAD患者.
- 根据性别,年龄和手术方法进行倾向得分匹配 (1:2比).
- 主要结局:在18个月的随访期间发生重大心血管和脑血管不良事件 (MACCE),包括死亡,心肌梗塞和中风.
主要成果:
- 在匹配后,ILVA组 (39名患者) 与对照组 (78名患者) 相比,MACCE (48.7%vs14.1%),全因死亡 (43.6%vs11.5%) 和中风 (12.8%vs2.6%) 的发病率显著更高.
- 独立的MACCE风险因素包括ILVA (HR=2.60),功能衰竭 (HR=1.93),心肺绕道时间 (HR=1.01).
- 修改后的兰金评分或住院死亡率没有显著差异.
结论:
- ATAAD患者患有ILVA在18个月的随访后,MACCE的发病率更高.
- ILVA,功能衰竭和心肺绕道时间被确定为ATAAD患者MACCE的独立风险因素.
- ILVA可能表明长期心血管风险增加,需要集中注意力来改善患者的治疗结果.
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