目的 探讨腹主动脉瘤腔内修复术后瘤体直径和瘤体体积的转归以及与术后内漏的关系。方法 回顾性分析2015年—2020年在我院行腹主动脉瘤腔内修复术的83例患者的临床及影像学资料。测量术前和术后各随访时间点瘤体最大直径及体积。CT评价术后内漏发生情况。定义瘤体（直径/体积）扩张/回缩及瘤体（直径/体积）稳定。以术前瘤体最大直径大小和术后内漏发生情况将患者分组,比较组间各随访时点的瘤体直径和体积转归情况。结果 患者术后平均随访时间24（10~62）个月。以瘤体直径<50 mm及≥50 mm分组,术后各随访时间点2组间瘤体体积及瘤体直径比较均无统计学差异。以术后有无内漏分组,术后各随访时间点组间比较瘤体体积变化比较差异均有统计学意义（P<0.05）,但瘤体直径变化组间比较差异均无统计学意义。结论 主动脉瘤瘤体体积与直径变化并不存在一致性,监测瘤体体积可以发现那些直径变化不明显的瘤体变化;腹主动脉瘤腔内修复术后内漏可能是导致瘤体增大的因素之一。

Objective To evaluate the outcome of aneurysm diameter and volume,and the role of endoleak after endovascular aneurysm repair of abdominal aortic aneurysm．Methods The clinical and imaging data from 83 patients who underwent endovascular repair of abdominal aortic aneurysm in our hospital from 2015 to 2020 were retrospectively analyzed．The maximum aneurysm diameter and volume were measured at the preoperative and postoperative follow-up time points．CT was used to evaluate the incidence of postoperative leakage．The aneurysm（diameter/volume）expansion/shrinkage and aneurysm（diameter/volume）stability were defined．Patients were divided into different groups according to the maximum preoperative aneurysm diameter and the incidence of postoperative endoleak,and the outcomes of aneurysm diameter and volume were compared at established follow-up points．Results The mean follow-up time was 24（10-62）months．There were no statistically significant differences in postoperative aneurysm volume and diameter at follow-up points between the patients with aneurysm diameter <50 mm and patients with aneurysm≥50 mm．There were statistically significant differences in postoperative aneurysm volume between the patients with postoperative endoleak and patients without postoperative endoleak（P<0.05）．However,there were no statistically significant differences in postoperative diameter between the two groups．Conclusions The changes of aneurysm volume and diameter were not closely related,and the detection of aneurysm volume can help to find the aneurysm changes with no obvious diameter changes．The postoperative endoleak after endovascular aneurysm repair may be one of the factors leading to aneurysm enlargement．

目的 探讨代谢综合征(metabolic syndrome, MS)(指包括高血压,糖尿病,高脂血症和腹型肥胖的一组综合征)在中国南方老年病人的患病率、及其与心血管事件和痴呆关系。方法 本研究为一个中国南方老年人代谢综合征的横断面研究。我们采集了患者的病史、人口学和生化资料。对比生化资料、心血管事件、痴呆等疾病在MS组和非MS组中的差异,并使用Logistic回归分析来寻找MS的独立影响因子。结果 本研究共纳入206例患者。其中有92(44.66%)例患者符合代谢综合征的诊断标准。女性在MS组中35例(38.04%)明显高于在非MS组中28例(24.56%)。整体年龄(86.74± 6.10),在MS组(86.37±5.74)和非MS组(87.04±6.38)对比中无统计学意义。生化资料对比中,白细胞[(7.46±2.38) vs (6.46±2.35),P=0.003]和血肌酐[94.50(68.50, 129.33) vs 78.00(64.50, 99.75),P=0.004]在MS组中较高。Logistics单因素回归分析及多因素回顾分析提示白细胞、血肌酐和女性为MS的独立风险因子。心肌梗塞(35例,38.04%和心绞痛(28例, 24.56%)在MS组中明显高于非MS组中心肌梗塞(10例,8.77%)和心绞痛(39例,34.21%),两组比较有统计学意义,Logistics回归分析发现MS是心肌梗塞和心绞痛的独立影响因子;但是心衰和中风在两组对比中无统计学差别。痴呆(包括老年性痴呆和血管性痴呆)在MS组中明显低于非MS组:26例(28.26%)vs 50例(43.86%),提示MS可能对痴呆有预防作用。结论 MS在中国南方老年患者中普遍存在,女性、白细胞、血肌酐为MS的独立影响因子;MS是心肌梗塞和心绞痛的独立影响因子;MS中痴呆明显低于非MS组,可能对痴呆有预防保护性作用。

Objective To study the prevalence and correlation between the metabolic syndrome MS (including hypertension, diabetes, hyperlipidemia and obesity) with cardiovascular and dementia in the elderly people of south China. Methods This cross-sectional research studied metabolic syndrome of the elderly in south China. We collected the demographics and chemotic data and compared them in MS and non-MS group. And Logistic regression was used to analyze the independent factor of MS and the relationship between MS and the cardiovascular disease and dementia. Results This study included 206 patients and 92 (44.66%) of them were diagnosed as MS. 35 patients (38.04%) in MS group were female and 28 female cases (24.56%) in non-MS group. The mean age of the sample was (86.74±6.10) and the comparison between the MS group (86.37±5.74) and non-MS group (87.04±6.38) was not significantly different. White blood cell (WBC) (7.46±2.38 vs 6.46±2.35,P=0.003) and serum creatinine (Scr) was significantly [94.50(68.50,129.33) vs 78.00(64.50, 99.75),P=0.004]in MS group versus in non-MS group. Single factor and Multinomial logistic regression found WBC, serum creatinine and female gender were the independent risk factors of MS. Myocardial infarction (35, 38.04%) and angina (28, 24.56%) were significantly higher in MS group than that in non-MS group (10, 8.77%) and (39, 34.21%), respectively, with P<0.05. Logistic regression found MS was an independent risk factor of myocardial infarction and angina but not in heart failure and stroke. Dementia (including Alzheimer disease and vascular dementia) was found lower in MS group (26, 28.26%) than that in non-MS group (50, 43.86%), the difference was significant and this means MS could be protective for dementia. Conclusion MS is prevalent in the elderly of south China. Female gender, WBC and Scr were independent factors of MS; MS was the independent risk factor of myocardial infarction and angina; dementia was significantly lower in MS group, implying MS could be protective to dementia.