| Objective:Aortic dissection is one of the common aortic diseases. It is very dangerous, and has a high mortality. Based on the clinical analysis of 190 patients with aortic dissection, a profound understanding of the clinical features of aortic dissection had come out. In order to reduce the mortality in patients with aortic dissection, the patients with different treatments had been followed up in early and intermediate-term.Methods:190 aortic dissection patients of the Department of Cardiology from January 2005 to May 2009 had been analyzed. The main analysis was about general condition, etiology, laboratory examinations, treatments and early and intermediate-term follow-up. The general condition had been analyzed, such as age distribution, sex ratio and aortic dissection type. The main cause of aortic dissection was hypertension. The main assistant examinations such as ECG, color Doppler echocardiography and multilayer spiral CT angiography (MSCTA) had been analyzed either. The laboratory examinations just like D-dimer, C-reactive protein, homocysteine, lipid, erythrocyte sedimentation rate, fibrinogen, WBC and cardiac troponin I had also been obtained. The main treatments were medical treatment, endovascular stent-graft repair and surgery. Blood pressure control and Multilayer Spiral CT Angiography of the patients had been followed up in early and intermediate-term. Results:190 AD patients had the similar age between the groups of men and women (t = 1.42, P = 0.158). Gender had nothing to do with the AD type (P> 0.05). Among the 190 patients, 147 patients had hypertension (77.4%), and 124 cases were male, 23 cases were female. The ratio was approximately 5:1. Among the 147 cases, 9 patients (6.1%) hadn't been treated by medicine, and 108 patients'(73.5%) blood pressure hadn't been controlled well. Among the 147 patients, there were 67cases (45.6%) with grade 3 hypertension, 39 cases (26.5%) with grade 2 hypertension and 41 cases (27.9%) with grade 1 hypertension. Although ultrasonography was better than Multilayer Spiral CT Angiography in diagnosis of aortic valve insufficiency and left ventricular function, Multilayer Spiral CT Angiography was more favorable than ultrasonography (P <0.05) in the diagnosis of aortic dissection. 24 patients had accepted the D-dimer testing. The mean was 1270.0 ng / l, and 95% confidence interval was (701, 4722) ng / l. Mortality was 18.2% of patients with typeâ… (10 cases), 11.1% (1 case) withâ…¡type, 11.3% (14 cases) withâ…¢type in 12 months. The mortality of the patients treated by medical therapy was 17.7% (22 cases), treated by endovascular treatment was 0% (0 cases), 8.8% (3 cases) in surgical patients.Conclusion:Hypertension is an important cause and a risk factor of aortic dissection. Poor control of blood pressure seriously affects the prognosis. Follow-up of patients'MSCTA can manage the healing of the break and give an intuitive assessment of the false and true lumen's diameters, and the absorption of thrombosis. CRP and ESR were significantly higher in aortic dissection patients, which might be due to the systemic inflammatory response and stress reaction. Although HCY, TG, HDL and fibrinogen were not in 95% confidence interval, there was no special significance in clinical practice between them. It was different in mortality between the patients who were treated by medical therapy, endovascular treatment and surgical treatment after one year follow-up. |
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