主動脈剝離年輕化，是什麼原因？有哪些症狀及如何預防，醫師來解答

曾有藝人因主動脈剝離造成血管阻塞而不幸離世，主動脈剝離屬於急性心血管疾病，根據衛生福利部109年死因統計，心臟病更是奪走國人性命的第二號殺手⁽¹⁾。究竟什麼是主動脈剝離?年輕人也會發生嗎?發生的症狀又有哪些?可以如何進一步預防呢?接下來，就為大家進行簡單的介紹。

 

什麼是主動脈剝離？

威而鋼100mg,犀利士20mg,樂威壯,必利勁

主動脈剝離(aortic dissection)是一個不算罕見但卻是致命的主動脈大血管疾病，發生年齡常見於40至70歲之間，根據粗略統計每年大約一百萬人中有5到30人罹患此疾病，其中又以男性病患居多，且大都有高血壓病史⁽²⁾。主動脈剝離的致病機轉是因為主動脈內膜的撕裂，血液經裂口進入主動脈中層，而使內膜與其周遭之中層、外層分開，形成所謂的假腔。當血流持續灌入假腔，則會導致原本的主動脈腔(又稱為真腔)缺乏血流並受到壓迫；主動脈中層本身的出血與隨後造成所覆蓋內膜的破裂，也是另一種可能的致病機轉⁽³⁾。

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主動脈剝離可能因血壓控制不良或遺傳疾病所導致，發作時常讓人措手不及，因此平時便應注意自身血壓、維持良好的生活型態，以減少主動脈剝離發生的機會，高危險族群更應定期接受檢查及治療，並做好緊急狀況發生的準備，才能將傷害減少至最低。

 

參考資料：https://www.dha.tw
1、衛生福利部 - 109年國人死因統計結果
2、台灣家庭醫學醫學會 - 鄭全皓、林益卿：主動脈剝離之診斷與治療。基層醫療 2014；29(8)：209-213
3、中華民國重症醫學會- 主動脈剝離多樣性臨床表徵 Taiwan Crit. Care Med.2008;9:133-144
4、James H Black, III, MDWarren J Manning, MD. Overview of acute aortic dissection and other acute aortic syndromes. Uptodate. Last updated: Jul 22, 2020.
5、Rajendra H Mehta, Patrick T O'Gara, Eduardo Bossone, Christoph A Nienaber, Truls Myrmel, Jeanna V Cooper, Dean E Smith, William F Armstrong, Eric M Isselbacher, Linda A Pape, Kim A Eagle, Dan Gilon, International Registry of Acute Aortic Dissection (IRAD) Investigators. Acute type A aortic dissection in the elderly: clinical characteristics, management, and outcomes in the current era. J Am Coll Cardiol. 2002 Aug 21;40(4):685-92. doi: 10.1016/s0735-1097(02)02005-3. PMID: 12204498
6、James L Januzzi, Eric M Isselbacher, Rossella Fattori, Jeanna V Cooper, Dean E Smith, Jianming Fang, Kim A Eagle, Rajendra H Mehta, Christoph A Nienaber, Linda A Pape, International Registry of Aortic Dissection (IRAD). Characterizing the young patient with aortic dissection: results from the International Registry of Aortic Dissection (IRAD). J Am Coll Cardiol. 2004 Feb 18;43(4):665-9. doi: 10.1016/j.jacc.2003.08.054. PMID: 14975480
7、James H Black, III, MDWarren J Manning, MD. Clinical features and diagnosis of acute aortic dissection. Uptodate. Last updated: Mar 11, 2021.
8、Linda A Pape, Mazen Awais, Elise M Woznicki, Toru Suzuki, Santi Trimarchi, Arturo Evangelista, Truls Myrmel, Magnus Larsen, Kevin M Harris, Kevin Greason, Marco Di Eusanio, Eduardo Bossone, Daniel G Montgomery, Kim A Eagle, Christoph A Nienaber, Eric M Isselbacher, Patrick O'Gara. Presentation, Diagnosis, and Outcomes of Acute Aortic Dissection: 17-Year Trends From the International Registry of Acute Aortic Dissection. J Am Coll Cardiol. 2015 Jul 28;66(4):350-8. doi: 10.1016/j.jacc.2015.05.029. PMID: 26205591
9、Priscilla Y Hsue, Cynthia L Salinas, Ann F Bolger, Neal L Benowitz, David D Waters. Acute aortic dissection related to crack cocaine. Circulation. 2002 Apr 2;105(13):1592-5. doi: 10.1161/01.cir.0000012524.44897.3a. PMID: 11927528
10、John A Elefteriades, Ioannis Hatzaras, Mary Ann Tranquilli, Andrew J Elefteriades, Robert Stout, Richard K Shaw, David Silverman, Paul Barash. Weight lifting and rupture of silent aortic aneurysms. JAMA. 2003 Dec 3;290(21):2803. doi: 10.1001/jama.290.21.2803. PMID: 14657063
11、Takagi H, Ando T, Umemoto T, (All-Literature Investigation of Cardiovascular Evidence [ALICE]Group). Meta-Analysis of Circadian Variation in the Onset of Acute Aortic Dissection. Am J Cardiol. 2017;120(9):1662. doi: 10.1016/j.amjcard.2017.07.067. Epub 2017 Jul 31. PMID: 28847596
12、Kojima S, Sumiyoshi M, Nakata Y, Daida H. Triggers and circadian distribution of the onset of acute aortic dissection. Circ J. 2002 Mar;66(3):232-5. doi: 10.1253/circj.66.232. PMID: 11922269
13、Evangelista A, Isselbacher EM, Bossone E, Gleason TG, Eusanio MD, Sechtem U, Ehrlich MP, Trimarchi S, Braverman AC, Myrmel T, Harris KM, Hutchinson S, O'Gara P, Suzuki T, Nienaber CA, Eagle KA, IRAD Investigators. Insights From the International Registry of Acute Aortic Dissection: A 20-Year Experience of Collaborative Clinical Research. Circulation. 2018 Apr 24;137(17):1846-1860. doi: 10.1161/CIRCULATIONAHA.117.031264. PMID: 29685932
14、Nallamothu BK, Mehta RH, Saint S, Llovet A, Bossone E, Cooper JV, Sechtem U, Isselbacher EM, Nienaber CA, Eagle KA, Evangelista A. Syncope in acute aortic dissection: diagnostic, prognostic, and clinical implications. Am J Med. 2002 Oct 15;113(6):468-71. doi: 10.1016/s0002-9343(02)01254-8. PMID: 12427495
15、James H Black, III, MDWarren J Manning, MD. Management of acute aortic dissection. Uptodate. Last updated: Nov 05, 2019.
16、衛生福利部 - 及早控制高血壓 降低主動脈剝離
17、Kathryn M Wales, Kristyn Kavazos, Maria Nataatmadja, Peter R Brooks, Chloe Williams, Fraser D Russell. N-3 PUFAs protect against aortic inflammation and oxidative stress in angiotensin II-infused apolipoprotein E-/- mice. PLoS One. 2014 Nov 14;9(11):e112816. doi: 10.1371/journal.pone.0112816. eCollection 2014. PMID: 25398022
18、Takuma Yoshihara, Kazunori Shimada, Kosuke Fukao, Eiryu Sai, Yayoi Sato-Okabayashi, Rie Matsumori, Tomoyuki Shiozawa, Hamad Alshahi, Tetsuro Miyazaki, Norihiro Tada, Hiroyuki Daida. Omega 3 Polyunsaturated Fatty Acids Suppress the Development of Aortic Aneurysms Through the Inhibition of Macrophage-Mediated Inflammation. Circ J. 2015;79(7):1470-8. doi: 10.1253/circj.CJ-14-0471. Epub 2015 Apr 30. PMID: 25925976
19、Tao Shang, Zhao Liu, Chang-jian Liu. Antioxidant Vitamin C attenuates experimental abdominal aortic aneurysm development in an elastase-induced rat model. J Surg Res. 2014 May 1;188(1):316-25. doi: 10.1016/j.jss.2013.11.1105. Epub 2013 Dec 6. PMID: 24484904
20、衛生福利部國民健康署- 國人膳食營養素參考攝取量 (第八版)

必利勁
樂威壯
犀利士5mg
泰國果凍威而鋼