Clinical Analysis Of 162 Cases With Acute Aortic Dissection

Objective To discuss the risk factors, clinical characteristics and associated prognostic factors of acute aortic dissection with different Standford types.Methods Retrospective analyses were conducted on clinical data of 162 patients with acute aortic dissection in China-Japan Friendship Hospital. The data was analysed according to Stanford type, risk factors, clinical manifestations and auxiliary examinations. Prognostic factors of acute aortic dissection were analysed by single factor and binary logistic regression analysis.Result Of all the acute aortic dissection patients, male sex was predominant, the mean age was (53.9±13.5) years (foreigners’mean age was 61 years), patients with type B were, on average, older ((56.7±12.9) years vs (50.4±13.4) years, p<0.05).87.0% of AAD patients were less than 65 years old. The most common four risk factors were hypertension (77.2%), smoking (53.1%), atherosclerosis (27.7%) and aortic aneurysm (18.5%). Pain was the most common clinical symptom of AAD patients, mostly located in the chest. Application of Latex (<0.5ng/ml) and ELISA (0～400ng/ml) methods to detect D-dimer, the sensitivities were 90.9% and 94.7% respectively, and the general sensitivity was 93.2%.91.5% patients were abnormal when detected by ultrasound (echocardiography), of which the sensitivity of type A was 100%, so it can be the first choice of hemodynamic instability patients, at the same time can be used for differential diagnose between AAD and acute myocardial infarction caused by AAD. As to prognosis, the mortality of type A was higher than type B (30.7% vs3.4%,p<0.05). When treated with surgery (stent), the mortality was declined obviously (8.5% vs 23.8%, p<0.05) while hospitalization. Confirmed time over 4 hours, presenting hypotension, shock, and (or)cardiac tamponade were independent risk factors for the prognosis of AAD.Conclusion Of all acute aortic dissection patients, male sex was predominant, patients with type B were, on average, older. Compared with foreigners’, the mean age of AAD patients’age in our country was younger. D-dimer test had high sensitivity and could exclude AAD when the result was negative. The high sensitivity of ultrasound examination can be a complementary diagnostic tool for critical AAD patients. Try to shorten the time of diagnosis and early operation can lower the mortality of AAD patients, and type A patients might benefit from surgery. Confirmed time over 4 hours, presenting hypotension, shock and (or) cardiac tamponade were independent risk factors for the prognosis of AAD.