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目的探讨并分析Stanford A型主动脉夹层患者术前发生全身炎症反应综合征(systemic inflammatory response syndrome,SIRS)的危险因素。方法回顾性分析157例Stanford A型主动脉夹层患者术前资料,对术前发生SIRS的影响因素分别进行单因素分析,单因素分析有意义的因素再进行多因素logistic回归分析独立危险因素。结果术前发生SIRS 74例,发生率47.13%;单因素分析显示年龄、夹层分期、左心室舒张末期内径、左心室收缩末期内径、主动脉瓣关闭不全程度、夹层内膜破口、夹层逆行剥离与Stanford A型主动脉夹层术前发生SIRS有关(P<0.1);多因素分析显示主动脉夹层分期(OR=0.259,95%CI:0.136~0.492,P=0.000)、左心室舒张末期内径(OR=0.901,95%CI:0.820~0.990,P=0.031)是Stanford A型主动脉夹层术前发生SIRS的独立危险因素。结论 Stanford A型主动脉夹层术前SIRS发生率高,主动脉夹层进入慢性期和左心室舒张末期内径扩大预示术前发生SIRS减弱或消退。
Objective To investigate and analyze the risk factors of systemic inflammatory response syndrome (SIRS) in patients with Stanford type A aortic dissection. Methods The data of 157 patients with Stanford type A aortic dissection were retrospectively analyzed. Univariate analysis was performed on the influencing factors of preoperative SIRS. Univariate analysis of significant factors followed by multivariate logistic regression analysis of independent risk factors. Results There were 74 cases of SIRS preoperatively, with a incidence of 47.13%. Univariate analysis showed that age, interphase, left ventricular end-diastolic diameter, end-systolic left ventricular diameter, aortic valve insufficiency, (P0. 0.259, 95% CI: 0.136-0.492, P = 0.000), left ventricular end-diastolic diameter (P <0.05), multivariate analysis showed that there was significant difference between the two groups OR = 0.901, 95% CI: 0.820-0.990, P = 0.031) were independent risk factors for SIRS before Stanford type A aortic dissection. Conclusions The incidence of SIRS before Stanford type A aortic dissection is high. The aortic dissection into the chronic phase and the increase of the left ventricular end-diastolic diameter indicate that preoperative SIRS weaken or dissipate.