急性主动脉综合征的诊治
| 作者: |
1龚龙家,
1袁也,
1,2王家宁,
1,3唐俊明
1 湖北医药学院附属人民医院临床医学研究所，湖北 十堰 442000 2 湖北医药学院附属人民医院心脏中心，湖北 十堰 442000 3 湖北医药学院 基础医学院生理学教研室，湖北 十堰 442000 |
| 通讯: |
王家宁
Email: rywjn@VIP.163.com |
| DOI: | 10.3978/j.issn.2095-6959.2017.06.032 |
| 基金: | 国家自然科学基金, 81270221，81170095 湖北省自然科学基金, 2014CFB644 |
摘要
急性主动脉综合征包括一类严重的、危及生命的主动脉疾病，包括急性主动脉夹层(aortic dissection，AD)、壁内血肿(intramural haematoma，IMH)、主动脉穿透性溃疡(penetrating aortic ulcer，PAU)，其中最常见的是主动脉夹层，其次为IMH、主动脉穿透性溃疡。先天性血管缺陷、遗传综合征和非遗传变异性综合征均是急性主动脉综合征的易患因素，可用CT、超声心动图、MRI等影像学方式来确诊。急性主动脉综合征的首要处理是控制血压以减少主动脉壁压力，其诊治往往需要一个多学科专家小组来评估并决定患者的治疗决策。急性主动脉综合征的最佳治疗方案仍然是一项具有挑战性的临床难题，需要进一步的研究来评价每种治疗方案的适用范围，制定以患者为本的精准治疗方案。
关键词：
急性主动脉综合征
主动脉夹层
壁内血肿
主动脉穿透性溃疡
高血压
冠状动脉粥样硬化
急性心肌梗死
心包压塞
Diagnosis and therapy of acute aortic syndrome
CorrespondingAuthor: WANG Jia’ning Email: rywjn@VIP.163.com
DOI: 10.3978/j.issn.2095-6959.2017.06.032
Abstract
Acute aortic syndrome (AAS) subsume a group of severe, life-threatening disorders of the aorta, including acute aortic dissection (AD), intramural haematoma (IMH), and penetrating aortic ulcer (PAU). The most frequent form of AAS is Aortic dissection, followed by IMH and PAU. Acute aortic syndrome (AAS) are susceptible to congenital cardiovascular defects, genetic syndromes, and non-syndromic genetic variants, which could be diagnosed by imaging modalities such as CT, echocardiography, and MRI. The foremost management of patients with AAS should focus on controlling of blood pressure to reduce aortic wall stress. Diagnose of patients with AAS will require professional support from a multidisciplinary team so as to decide therapeutic strategy for patients. The optimal treatment of patients with AAS remains fairly challenging clinical quandary, further studies are required to fully characterize conditions within the AAS spectrum and to design precision, patient-centred treatment plans.