不同肠系膜上动脉缺血性疾病60例分析

doi:10.3760/cma.j.issn.1007-1245.2024.17.024

国际医药卫生导报 ›› 2024, Vol. 30 ›› Issue (17): 2941-2945.DOI: 10.3760/cma.j.issn.1007-1245.2024.17.024

不同肠系膜上动脉缺血性疾病60例分析

李恒¹ 蒋士杰² 连鹏² 张晖¹

¹西安高新医院放射科，西安　710075；²西安市人民医院西安市第四医院医学影像中心，西安　710004

收稿日期:2024-05-20 出版日期:2024-09-01 发布日期:2024-09-23
通讯作者: 张晖，Email：20224088@qq.com
基金资助:
陕西省重点研发计划（2024SF-YBXM-232）；西安市第四医院科研孵化基金（2020-FZ-64）

Analysis on 60 cases of different superior mesenteric artery ischemic diseases

Li Heng¹, Jiang Shijie², Lian Peng², Zhang Hui¹

¹Department of Radiology, Xi'an High-tech Hospital, Xi'an 710075, China; ²Medical Imaging Center, Xi'an People's Hospital, Xi'an Fourth Hospital, Xi'an 710004, China

Received:2024-05-20 Online:2024-09-01 Published:2024-09-23
Contact: Zhang Hui, Email: 20224088@qq.com
Supported by:
Key Plan for Research and Development in Shaanxi (2024SF-YBXM-232); Scientific Research Hatching Fund of Xi'an Fourth Hospital (2020-FZ-64)

摘要/Abstract

摘要：

目的　探讨不同肠系膜上动脉缺血性疾病（SMAI）患者的临床特征、影像学特点及危险因素。方法　回顾性分析2019年12月至2022年12月西安高新医院收治的60例SMAI患者的临床资料，其中男40例，女20例，年龄（66.47±10.33）岁；其中，肠系膜动脉夹层（SMAD）患者28例，肠系膜动脉栓塞（SMAE）患者18例，肠系膜动脉血栓（SMAT）患者14例。采用F检验或χ²检验比较SMAD组、SMAE组、SMAT组临床资料，logistic回归分析SMAI发生的危险因素。结果　SMAD组年龄、高血压占比、房颤占比、中性粒细胞百分比及纤维蛋白原、D二聚体水平分别为（64.37±2.20）岁、19例（67.86%）、1例（3.57%）、（77.70±3.52）%、（4.25±0.62）g/L及（4.65±0.44）mg/L，与SMAE组［（68.55±3.25）岁、17例（94.44%）、10例（55.56%）、（88.71±4.50）%、（4.86±0.80）g/L及（3.97±0.53）mg/L］、SMAT组［（64.88±2.25）岁、8例（57.14%）、1例（7.14%）、（82.59±4.38）%、（4.20±0.69）g/L及（4.15±0.42）mg/L］相比，差异均有统计学意义（均P<0.05）。将影响因素纳入多因素logistic回归分析，结果显示，年龄［比值比（OR）=1.394，95% 置信区间（CI）1.135～1.712］、高血压（OR=1.910，95%CI 1.127～3.236）、房颤（OR=2.140，95%CI 1.084～4.225）、中性粒细胞（OR=3.080，95%CI 1.336-7.099）、纤维蛋白原（OR=3.554，95%CI 1.167～10.819）、D二聚体（OR=3.242，95%CI 3.214～24.821）均为SMAI发病的危险因素（均P<0.05）。结论　SMAI好发于老年人群，常合并高血压、房颤等并发症，CT影像表现为肠壁增厚、肠腔扩张、腹腔积液等。年龄、高血压、房颤、中性粒细胞、纤维蛋白原、D二聚体均为SMAI发病危险因素。

关键词:

肠系膜上动脉疾病, 临床特征, 影像学特点, 危险因素

Abstract:

Objective　To investigate the clinical features, imaging features, and risk factors of patients with different superior mesenteric artery ischemic diseases (SMAI). Methods　The clinical data of 60 patients with SMAI treated at Xi'an High-tech Hospital between December 2019 and December 2022 were retrospectively analyzed. There were 40 males and 20 females. They were (66.47±10.33) years old. Among them, there were 28 cases of mesenteric artery dissection (SMAD), 18 cases of mesenteric artery embolism (SMAE), and 14 cases of mesenteric artery thrombosis (SMAT). The clinical data of the SMAD group, the SMAE group, and the SMAT group were compared by t test or χ² test. The risk factors of SMAI were analyzed by logistic regression. Results　The age, proportions of the patients with hypertension and atrial fibrillation, neutrophil percentage, and levels of fibrinogen and D dimer in the SMAD group were (64.37±2.20) years, 19 cases (67.86%), 1 case (3.57%), (77.70±3.52)%, (4.25±0.62) g/L, and (4.65±0.44) mg/L; those in the SMAE group were (68.55±3.25) years, 17 cases (94.44%), 10 cases (55.56%), (88.71±4.50)%, (4.86±0.80) g/L, and (3.97±0.53) mg/L; those in the SMAT group were (64.88±2.25) years, 8 cases (57.14%), 1 case (7.14%), (82.59±4.38)%, (4.20±0.69)g/L, and (4.15±0.42) mg/L; there were statistical differences (all P<0.05). The influencing factors were included in the multivariate logistic regression analysis, and the results showed that age [odds ratio (OR)=1.394, 95% confidence interval (CI) 1.135-1.712], hypertension (OR=1.910, 95%CI 1.127-3.236), atrial fibrillation (OR=2.140, 95%CI 1.084-4.225), neutrophils (OR=3.080, 95%CI 1.336-7.099), fibrinogen (OR=3.554, 95%CI 1.167-10.819), and D-dimer (OR=3.242, 95%CI 3.214-24.821 were risk factors for SMAI (all P<0.05). Conclusions　SMAI tends to occur in the elderly population and is often complicated with hypertension, atrial fibrillation, and other complications. Its CT imaging shows intestinal wall thickening, intestinal dilation, abdominal fluid accumulation, etc. Age, hypertension, atrial fibrillation, neutrophil, fibrinogen, and D-dimer are risk factors for SMAI.

Key words:

Superior mesenteric artery diseases, Clinical features, Imaging features, Risk factors

李恒蒋士杰连鹏张晖.

不同肠系膜上动脉缺血性疾病60例分析 [J]. 国际医药卫生导报, 2024, 30(17): 2941-2945.

Li Heng, Jiang Shijie, Lian Peng, Zhang Hui.

Analysis on 60 cases of different superior mesenteric artery ischemic diseases [J]. International Medicine and Health Guidance News, 2024, 30(17): 2941-2945.

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不同肠系膜上动脉缺血性疾病60例分析

Analysis on 60 cases of different superior mesenteric artery ischemic diseases

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