徐平 1 , 湯勇 2
  • 自貢市第四人民醫(yī)院（四川自貢，643000） 1 急診科，2心內科;

【摘要】　 急性主動脈夾層病死率高，病情兇險，臨床表現(xiàn)復雜多變，早期誤診率及病死率高。因此采用科學合理、操作性強的急診診斷流程進行早期篩查顯得至關重要。急診篩查流程包括危險患者識別、床旁風險評估及輔助檢查確診等步驟，通過篩查盡早對高?；颊哌M行影像學確診并給予及時有效干預，從而減少誤診率、改善預后。

引用本文： 徐平,湯勇. 急性主動脈夾層急診診斷研究進展. 華西醫(yī)學, 2011, 26(8): 1256-1258. doi: 復制

1. 　Tang M, Liu QM, Zhou SH, et al. Analysis on an early diagnosis grading model for acute aortic dissection[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2010, 38(5): 425-428.
2. 　Siegal EM. Acute Aortic Dissection[J]. J Hosp Med, 2006, 1(2): 94-105.
3. 　Setacci F, Sirignano P, de Donato G, et al. Acute aortic dissection: natural history and classification[J]. J Cardiovasc Surg(Torino), 2010, 51(5): 641-646.
4. 　Kasher JA, El-Bialy A, Balingit P. Aortic dissection: a dreaded disease with many faces[J]. J Cardiovasc Pharmacol Ther, 2004, 9(3): 211-218.
5. 　Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/ SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine[J]. Circulation, 2010, 121(13): 266-369.
6. 　Kamalakannan D, Rosman HS, Eagle KA. Acute aortic dissection[J]. Crit Care Clin, 2007, 23(4): 779-800.
7. 　Braverman AC. Acute Aortic Dissection: Clinician Update[J]. Circulation, 2010, 122(2): 184-188.
8. 　Juang D, Braverman AC, Eagle K. Cardiology patient pages.Aortic dissection[J]. Circulation, 2008, 118(14): 507-510.
9. 　Tsai TT, Trimarchi S, Nienaber CA. Acute aortic dissection: perspectives from the International Registry of Acute Aortic Dissection(IRAD)[J]. Eur J Vasc Endovasc Surg, 2009, 37(2): 149-159.
10. 　Ryu HM, Lee JH, Kwon YS, et al. Examining the relationship between triggering activities and the circadian distribution of acute aortic dissection[J]. Korean Circ J, 2010, 40(11): 565-572.
11. 　Sumiyoshi M, Kojima S, Arima M, et al. Circadian, weekly, and seasonal variation at the onset of acute aortic dissection[J]. Am J Cardiol, 2002, 89(5): 619-623.
12. 　del Porto F, Proietta M, Tritapepe L, et al. Inflammation and immune response in acute aortic dissection[J]. Ann Med, 2010, 42(8): 622-629.
13. 　Wen D, Zhou XL, Li JJ, et al. Biomarkers in aortic dissection[J]. Clin Chim Acta, 2011, 412(9-10): 688-695.
14. 　Komukai K, Shibata T, Mochizuki S. C-reactive protein is related to impaired oxygenation in patients with acute aortic dissection[J]. Int Heart J, 2005, 46(5): 795-799.
15. 　Sakakura K, Kubo N, Ako J, et al. Peak C-reactive protein level predicts long-term outcomes in type B acute aortic dissection[J].Hypertension, 2010, 55(2): 422-429.
16. 　菲妮娜?木拉提, 張源明. 主動脈夾層診斷進展[J]. 中華胸心血管外科雜志, 2010, 26(4): 281-283.
17. 　Ranasinghe AM, Bonser RS. Biomarkers in acute aortic dissection and other aortic syndromes[J].J Am Coll Cardiol, 2010, 56(19): 1535-1541.
18. 　Apostolakis E, Akinosoglou K. What’s new in the biochemical diagnosis of acute aortic dissection: problems and perspectives[J]. Med Sci Monit, 2007, 13(8): RA154-158.
19. 　Suzuki T, Distante A, Zizza A, et al. Diagnosis of acute aortic dissection by D-dimer: the International Registry of Acute Aortic Dissection Substudy on Biomarkers(IRAD-Bio) experience[J]. Circulation. 2009, 119(20):2702-2707.
20. 　Ince H, Nienaber CA. Diagnosis and management of patients with aortic dissection[J]. Heart, 2007, 93(2): 266-270.
  1. 1. 　Tang M, Liu QM, Zhou SH, et al. Analysis on an early diagnosis grading model for acute aortic dissection[J]. Zhonghua Xin Xue Guan Bing Za Zhi, 2010, 38(5): 425-428.
  2. 2. 　Siegal EM. Acute Aortic Dissection[J]. J Hosp Med, 2006, 1(2): 94-105.
  3. 3. 　Setacci F, Sirignano P, de Donato G, et al. Acute aortic dissection: natural history and classification[J]. J Cardiovasc Surg(Torino), 2010, 51(5): 641-646.
  4. 4. 　Kasher JA, El-Bialy A, Balingit P. Aortic dissection: a dreaded disease with many faces[J]. J Cardiovasc Pharmacol Ther, 2004, 9(3): 211-218.
  5. 5. 　Hiratzka LF, Bakris GL, Beckman JA, et al. 2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/ SIR/STS/SVM guidelines for the diagnosis and management of patients with thoracic aortic disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine[J]. Circulation, 2010, 121(13): 266-369.
  6. 6. 　Kamalakannan D, Rosman HS, Eagle KA. Acute aortic dissection[J]. Crit Care Clin, 2007, 23(4): 779-800.
  7. 7. 　Braverman AC. Acute Aortic Dissection: Clinician Update[J]. Circulation, 2010, 122(2): 184-188.
  8. 8. 　Juang D, Braverman AC, Eagle K. Cardiology patient pages.Aortic dissection[J]. Circulation, 2008, 118(14): 507-510.
  9. 9. 　Tsai TT, Trimarchi S, Nienaber CA. Acute aortic dissection: perspectives from the International Registry of Acute Aortic Dissection(IRAD)[J]. Eur J Vasc Endovasc Surg, 2009, 37(2): 149-159.
  10. 10. 　Ryu HM, Lee JH, Kwon YS, et al. Examining the relationship between triggering activities and the circadian distribution of acute aortic dissection[J]. Korean Circ J, 2010, 40(11): 565-572.
  11. 11. 　Sumiyoshi M, Kojima S, Arima M, et al. Circadian, weekly, and seasonal variation at the onset of acute aortic dissection[J]. Am J Cardiol, 2002, 89(5): 619-623.
  12. 12. 　del Porto F, Proietta M, Tritapepe L, et al. Inflammation and immune response in acute aortic dissection[J]. Ann Med, 2010, 42(8): 622-629.
  13. 13. 　Wen D, Zhou XL, Li JJ, et al. Biomarkers in aortic dissection[J]. Clin Chim Acta, 2011, 412(9-10): 688-695.
  14. 14. 　Komukai K, Shibata T, Mochizuki S. C-reactive protein is related to impaired oxygenation in patients with acute aortic dissection[J]. Int Heart J, 2005, 46(5): 795-799.
  15. 15. 　Sakakura K, Kubo N, Ako J, et al. Peak C-reactive protein level predicts long-term outcomes in type B acute aortic dissection[J].Hypertension, 2010, 55(2): 422-429.
  16. 16. 　菲妮娜?木拉提, 張源明. 主動脈夾層診斷進展[J]. 中華胸心血管外科雜志, 2010, 26(4): 281-283.
  17. 17. 　Ranasinghe AM, Bonser RS. Biomarkers in acute aortic dissection and other aortic syndromes[J].J Am Coll Cardiol, 2010, 56(19): 1535-1541.
  18. 18. 　Apostolakis E, Akinosoglou K. What’s new in the biochemical diagnosis of acute aortic dissection: problems and perspectives[J]. Med Sci Monit, 2007, 13(8): RA154-158.
  19. 19. 　Suzuki T, Distante A, Zizza A, et al. Diagnosis of acute aortic dissection by D-dimer: the International Registry of Acute Aortic Dissection Substudy on Biomarkers(IRAD-Bio) experience[J]. Circulation. 2009, 119(20):2702-2707.
  20. 20. 　Ince H, Nienaber CA. Diagnosis and management of patients with aortic dissection[J]. Heart, 2007, 93(2): 266-270.