摘要目的 探讨主动脉夹层危险因素,临床表现与预后的性别差异. 方法 回顾分析广东省心血管病研究所1997年1月-2006年12月连续收治确诊为主动脉夹层的患者,对不同性别患者合并高血压病与吸烟状况、超声测量室间隔与左室后壁厚度、夹层类型、治疗方法及预后进行统计并比较分析. 结果 共入选合格病例418份,男女之比5.33∶1.男性组与女性组平均年龄分别为(55.1±11.3)岁和(58.0 ±12.1)岁;高血压病患病率分别为71.6%(252/352)和65.2%(43/66).男性组56.5%(199/352)有明确大量吸烟史,女性组只有13.6%(9/66),远低于男性(P=0.00).在户籍广州的急性主动脉病例中,男性患者较倾向于接受外科或主动脉腔内隔绝术(25/78对3/18,x2=1.68,P=0.20),而女性患者住院病死率和一年预后都有优于男性的趋势(2/18对18/78,x2=1.27,P=0.26),但未达统计学差异. 结论 在广东,主动脉夹层的男性患病率约是女性5倍.女性患者有大量吸烟史的比例是本地区一般成年女性吸烟率的3倍余.尽管男性AD患者较倾向接受外科和主动脉腔内隔绝术治疗,但女性患者的短期预后似乎更好.

abstractsObjective To investigate gender-related differences in risk factors,clinical manifestation and outcomes in patients with aortic dissection(AD)from Guangzhou.Methods Consecutive patients with AD admitted to our institute over the past 10 years were included in this retrospective analysis.Prevalence of hypertension, smoking, thickness of intraventricular septum and left ventricular posterior wall measured by echocardiography,and outcomes were compared between male and female AD patients.Results There were more male AD patients than female AD patients(5.33:1) from the 418 patients.Prevalence of hypertension, thickness of intraventricular septum and left ventricular posterior wall were similar in male and female AD patients.Heavy smoking history was 56.5%in males and 13.6%in females(P=0.000).Acute survival rate in female patients tended to be better than that in male patients.Conclusions There were significantly more male AD patients than female AD patients in this cohort.Prevalence of heave smoking in male patients is 3 times hisher than that in female population.