Abstract：
This study aimed to identify the clinical characteristics associated with spontaneous isolated dissection of superior mesenteric artery/celiac artery (SIDSMA/SIDCA). This observational study, conducted at Toranomon Hospital, Japan between 2009 and 2020, analyzed consecutive SIDSMA/SIDCA cases based on radiology data. The study compared clinical characteristics between symptomatic and asymptomatic patients with SIDSMA/SIDCA and investigated factors related to future vessel dilatation. Among 57 cases (44 SIDSMA, 17 SIDCA, and 4 both), the majority were male (87.7%), nearly half having hypertension (43.9%) and smokers (48.9%). Of those, 17 cases (29.8%) were symptomatic; abdominal pain (94.1%), back pain (23.5%), nausea (17.6%) and fever (5.9%). The symptomatic group was younger (52.6 ± 9.4 versus 67.2 ± 7.9 years, P < 0.001), had higher systolic and mean blood pressure (142.6 ± 20.0 versus 129.5 ± 16.5 mmHg, P = 0.017; 96.1 ± 14.6 versus 88.2 ± 17.7 mmHg, P = 0.038), a higher white blood cell count (9975 ± 5032 versus 6268 ± 1991 /µL, P = 0.012), and a higher LDL cholesterol level at diagnosis (129.7 ± 21.7 versus 87.2 ± 25.6 mg/dL, P = 0.002) than the asymptomatic group. The factors associated with future vessel dilatation included the presence of pseudo-lumen flow in the dissection vessel (73.9% versus 41.4%, p = 0.019) and a larger vessel diameter (13.5 ± 2.4 mm versus 11.5 ± 2.1 mm, p = 0.005) at diagnosis after multiple adjustments, pseudo-lumen flow was a predictor of future vessel dilatation (odds ratio, 4.80; 95% confidence interval, 1.11-20.75; p = 0.036). The study revealed that only 30% of SIDSMA/SIDCA cases were symptomatic. Symptomatic cases were generally younger and exhibited higher blood pressure and elevated white blood cell counts. These findings offer valuable insights for the acute diagnosis of SIDSMA/SIDCA.
摘要：
本研究旨在确定与自发性孤立性肠系膜上动脉/腹腔动脉夹层（SIDSMA/SIDCA）相关的临床特征。这项观察性研究,在托罗诺蒙医院进行，日本在2009年至2020年期间，根据放射学数据分析了连续的SIDSMA/SIDCA病例。该研究比较了SIDSMA/SIDCA有症状和无症状患者的临床特征，并调查了与未来血管扩张相关的因素。57例（44SIDSMA，17SIDCA,和4两者)，大多数是男性(87.7%)，近一半患有高血压(43.9%)和吸烟者(48.9%)。其中,有症状者17例(29.8%);腹痛(94.1%),背痛（23.5%），恶心（17.6%）和发热（5.9%）。有症状组较年轻（52.6±9.4与67.2±7.9岁，P<0.001)，收缩压和平均血压较高（142.6±20.0对129.5±16.5mmHg，P=0.017；96.1±14.6对88.2±17.7mmHg，P=0.038),较高的白细胞计数（9975±5032对6268±1991/µL，P=0.012),诊断时LDL胆固醇水平较高（129.7±21.7vs87.2±25.6mg/dL，P=0.002)比无症状组。与未来血管扩张相关的因素包括夹层血管中存在假腔血流（73.9％对41.4％，p=0.019）和较大的血管直径（13.5±2.4mm对11.5±2.1mm，p=0.005)在多次调整后诊断时，假腔血流是未来血管扩张的预测因子(比值比，4.80；95%置信区间，1.11-20.75；p=0.036）。研究表明，只有30％的SIDSMA/SIDCA病例有症状。有症状的病例通常较年轻，血压较高，白细胞计数升高。这些发现为SIDSMA/SIDCA的急性诊断提供了有价值的见解。
