Study On Pathogenesis And Surgical Treatment Of Aortic Dissection

Objective:Reasearchingthe association between the gene polymorphism in the promoter of matrix metalloproteinases 12 and aortic dissection.Methods:All the casesare from September 2012 to December 2012 in the NO.4 affiliated hospital of Kunming medical university. The blood of the 45 patients with Stanford Type A acute aortic dissectionis recovery who was underwent surgery asthe experimental.The blood 35 patients with myocardial infarction underwent the coronary artery bypass surgery over as the control group.Extract the DNA of all the cases by using the phenol-chloroform method, and sequence the MMP-12 promoter regions by Sanger method, then compare with the Reference Sequenceof MMP-12 promoter regions （NM₀02426.4）.The sequencing results compare with its promoter regions and look for if there are single nucleotide polymorphisms.Results:According to the result, the SNP in the MMP-12 promoter regions will be as follow:The nucleotides T of 220 becomes into C and the nucleotides Cof 645becomes into T. One of the most common gene polymorphism is the T220Cin theMMP-12 promoter regions. All the polymorphismhas appeared in the experimental group. The nucleotide T lessfrequently in the experimental group than the control group （OR=0.856,95% CI=0.786-0.931）, the result is tatistically significant （x2=11.01, P<0.05）.And 645th nucleotide allele C and T distribution no statistical difference in the experimental group and the control group （x = 0.783, P> 0.05）.Therefore, there may be no relationship between the C645T polymorphism and the AD.The frequency of the nucleotides T in the experimental group（1.1%） and control group（0%） were similar, and with nucleotides T mutation may be related to the AD （OR= 0.989,95% CI= 0.967-1.011）.Conclusion:The T220C polymorphism in the MMP-12 promoter sequences is relationship with the incidence of aortic dissection. The ucleotide C mutation can result in groups are more likely to suffer from aortic dissection.Objective: To study the opportunky of the femoi’al artery bypass grafting surgery for Stanford. A complex aortic dissection.Methods: 31 cases with type A sticklebacks, aortic dissection, age（4th 15） ye% weight（73±15）kg, test the patients’renal function before the surgery, and application of Toshiba Aquilion ONE 320 CT scan chest and abdomen aorta, and calculate the smallest true lumen area and the descending aorta are the same plane descending aorta area,test the systolic blood differential pressure and urine volume in 1 hour. Results: The opportunity of the femoral artery bypass ’grafting surgery is influence by the factors as fbllow:（1）the proportion of the minimum true lumen area in the descending aorta area < 1.5%;（2） the upper and lower limb syrgolic blood differential pressure is about 30⁵0mmHg;（3） the urine volume is little,or and the diuretic effect is not good.（4） the descending aorta distal without breaking Conclusion: Test the Stanfbrd A compkx aortic dissection factor as follow:the true lumen of minimum area,the upper and lower limbs rgstolic blood pressure differential,the urine of thawing stage and the descending aorta distal crevasse monitoring. We can be decided the operation opportunity of the femoral artery bypass grafting surgery, it is positive to the patients’prognosis.Objective: To explorelong-term prognosis of the patients with Stanford type A aortic dissection after Sun’s surgery and ascending aorta- femoral artery bypass graftingMethods: All the.casesare from September 2012 to December 2012 in the NO. 4 affihated hospital of Kunming medical university. 12 patients with aortic dksecticm has adopted Sun’s surgery and ascending aorta-femoral artery bypass grafting treatment,andmonitor these patients’ renal flinction. and the enhanced thoracic aorta CT scaiming through the postoperative one month, three months, six months, one year to in the area of the descending aorta and its true lumen area measurement and compared with preoperative condition, at the same time four monitoring bypass vascular area size and compare.Results;（1） The areaofbypass vesselshave no significant change in one year, it has ahigh patency rate in 1 year;（2）The renal function is not damaged in 1 year;（3） The descending aorta is not obvious expansion in 1year;（4） The true lumen of the descending aorta is obvious expansion, and the lower half of the perfiisionhas been increased.CoiicliisiGns:TheAD patients with smalltrue lumen and the lower body perfiision adopted the positive gained- shares bypass grafting in patients with long-term prognosis is of positive significance...