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Circulation:妊娠期主动脉夹层或破裂的风险

2016-08-18 MedSci MedSci原创

主动脉夹层或破裂的风险在怀孕和产后期间明显升高。

一系列病例报道了在怀孕期间可能发生主动脉夹层及破裂,然而很少有以人群为基础的研究数据支持这种关联。

来自于费尔家庭大脑和心理研究所神经内科的Kamel教授及其团队对美国加州、佛罗里达州和纽约所有非联邦医疗场所内的急诊和急性住院的病人的相关数据进行队列交叉研究分析。研究纳入2005年和2013年期间,年龄大于12岁有过分娩或流产经历的女性,研究的终点事件是发生主动脉夹层或破裂。在妊娠期间发生主动脉并发症即时报告,研究将分娩前6个月到分娩结束后3个月确定为风险期。在此期间,比较了每个患者发生主动脉并发症的可能性,发病率和发病率比值使用条件Poisson 回归模型进行计算。 

研究结果显示在4 933 697名女性共发生6 566 826次怀孕记录(其中有研究者在研究期间发生2-3次妊娠),其中有36例孕妇在风险期内发生主动脉夹层或破裂,另有9例在风险期1年后发生主动脉夹层或破裂。主动脉并发症的发生率为5.5(95%置信区间为4.0-7.8)人每百万名妊娠妇女,而产后一年为1.4(95%置信区间为0.7-2.9)每百万名妊娠妇女。相比于产后1年的女性,妊娠显著增加主动脉夹层或破裂的风险(发病率之比为4.0,95%置信区间为2.0-8.2)。 

Kamel教授及其团队的研究结果提示主动脉夹层或破裂的风险在怀孕和产后期间明显升高。 

原始出处: 

Hooman Kamel, et al. Pregnancy and the Risk of Aortic Dissection or Rupture A Cohort-Crossover Analysis. Circulation. 2016 August 04.

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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 10:47:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105410, encodeId=6f8610541032, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sat Aug 27 09:22:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104200, encodeId=5c1f1042002e, content=深度好文,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), 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    2016-09-27 ylzr123

    关注值得学习。赞!好文有待探究。

    0

  2. 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    2016-09-25 1e10c84am36(暂无匿称)

    文章很好值得关注

    0

  3. 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), 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    2016-08-31 1771ae4158m

    学习了,好

    0

  4. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 10:47:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105410, encodeId=6f8610541032, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sat Aug 27 09:22:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104200, encodeId=5c1f1042002e, content=深度好文,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415070, encodeId=ac1b14150e013, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=)]
    2016-08-28 李东泽

    很好,不错学习。

    0

  5. 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415070, encodeId=ac1b14150e013, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=)]
    2016-08-27 1771ae4158m

    学习了,好

    0

  6. 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), 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    2016-08-26 ylzr123

    深度好文,赞一个!!!

    0

  7. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 10:47:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105410, encodeId=6f8610541032, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sat Aug 27 09:22:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104200, encodeId=5c1f1042002e, content=深度好文,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo7s7ZCKOmmbBTD6nE7gcd5OZpvyGEzkxBP3S275k5ZJVrsPkotZhBglRHM9rKvcj1OgkssqhcnoPw8zIaMZTF8c/0, createdBy=4c441942088, createdName=ylzr123, createdTime=Fri Aug 26 09:11:00 CST 2016, time=2016-08-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=102358, encodeId=effe102358ca, content=谢谢啦,很详细, beContent=null, objectType=article, channel=null, level=null, likeNumber=58, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NfdY7yem1P7bRvOP6z0jKsBoYR8ezfAricY7meQWcte7LRJsWHVn0CnPJg2JuQmevR0DoFmmEib5QLD2kNESBESQT/0, createdBy=59191706502, createdName=医路开来, createdTime=Mon Aug 22 21:09:00 CST 2016, time=2016-08-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=101510, encodeId=7e9710151022, content=值得学习, beContent=null, objectType=article, channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1415070, encodeId=ac1b14150e013, content=<a href='/topic/show?id=04812314540' target=_blank style='color:#2F92EE;'>#主动脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=46, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=23145, encryptionId=04812314540, topicName=主动脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=77603112682, createdName=circumcision, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=)]
    2016-08-22 医路开来

    谢谢啦,很详细

    0

  8. 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createdAvatar=https://wx.qlogo.cn/mmopen/jW482SpianMayicTRbRZ5RzUn81b5CF5ibVPib8jWI92iciaxmqGHlwruOnK4SVZykd4iahqo1hicklIibyZoxm55X7EM8BW9eX1h1hQ2/0, createdBy=8aa81937526, createdName=李东泽, createdTime=Sun Aug 28 10:47:00 CST 2016, time=2016-08-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=105410, encodeId=6f8610541032, content=学习了,好, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/11/23/ac01daf0962458a9eb8c0b1e2f6ce5bc.jpg, createdBy=04b81710322, createdName=1771ae4158m, createdTime=Sat Aug 27 09:22:00 CST 2016, time=2016-08-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=104200, encodeId=5c1f1042002e, content=深度好文,赞一个!!!, beContent=null, objectType=article, channel=null, level=null, likeNumber=83, replyNumber=0, topicName=null, topicId=null, 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channel=null, level=null, likeNumber=66, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLMzGpMQ8w4I7FpiblCXNcmI6O7TDINutbaicEUpoYFR1rWqn3kTbulfMhT0iaPFurLz2ddEcWe3BiciaQ/0, createdBy=5f6e1724878, createdName=136****0753赵, createdTime=Sat Aug 20 15:21:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250999, encodeId=e62e125099993, content=<a href='/topic/show?id=90494486837' target=_blank style='color:#2F92EE;'>#妊娠期#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=44868, encryptionId=90494486837, topicName=妊娠期)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=0b7c20, createdName=wjcjjian, createdTime=Sat Aug 20 02:26:00 CST 2016, time=2016-08-20, status=1, ipAttribution=), 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    2016-08-20 136****0753赵

    值得学习

    0

  9. 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  10. 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