The incidence of acute aortic dissection with type 2 diabetes is on the rise; however, relatively little research has been done on its risk factors and prognosis. Therefore, actively seeking a simple and effective diagnostic tool has become the focus of research.

To analyze the risk factors, prognosis and rapid screening of AAD patients with type 2 diabetes.

A total of 168 patients with AAD admitted to Ningbo Medical Center Li Huili Hospital from January 2016 to October 2022 were selected as the study objects, and the patients were initially screened and triaged using the aortic dissection detection risk score (ADD-RS) table. Aortic CTA was selected as the "gold standard" for the diagnosis of AAD, and the diagnostic results of aortic CTA were compared with the preliminary screening results of ADD-RS. The general data of the diabetic group and the non-diabetic group were compared, and the risk factors of type 2 diabetes in AAD patients were analyzed by multivariate Logistic regression analysis. The short-term prognosis and pain score of the two groups were compared. The factors influencing the short-term prognosis of AAD patients were analyzed by Cox regression analysis, and the predictive value of ADD-RS was analyzed by ROC curve.

59 patients with AAD combined with type 2 diabetes (diabetes group) and 109 patients with AAD combined with non-diabetes (non-diabetes group) were screened by ADD-RS table. Multivariate Logistic regression analysis showed that increased age (OR=1.088, 95%CI=1.042-1.136, P<0.001), BMI≥25 kg/m² (OR=2.000, 95%CI=1.421-2.834, P<0.001), coronary heart disease (OR=7.654, 95%CI=1.850-31.677, P=0.005), hyperlipidemia (OR=4.948, 95%CI=1.384-17.681, P=0.014), and LVEF (OR=1.199, 95%CI=1.109-1.297, P<0.001) were risk factors for AAD combined with type 2 diabetes. There was no statistically significant difference in pain score between AAD patients with or without diabetes mellitus (P>0.05), and the 30-day mortality of the two groups was 3.39% and 3.67%, respectively, with no statistically significant difference between the two groups (P>0.05). Cox regression analysis showed that hypertension was not an independent factor affecting the short-term prognosis of patients with acute aortic dissection (HR=0.673, 95%CI=0.094-4.791, P>0.05). The ADD-RS score of the diabetic group was 1 ⁽¹⁾, significantly higher than that of the AAD patients in the non-diabetic group 1 ⁽²⁾ (Z=-4.640, P<0.001). The high risk and moderate risk in diabetic group were higher than those in non-diabetic group (Z=2.309, P=0.021). The maximum area under ROC curve is 0.706 (95%CI=0.634-0.779) .

Risk factors for AAD patients with type 2 diabetes include age, BMI≥25 kg/m², coronary heart disease, hyperlipidemia, and LVEF. Moreover, ADD-RS score has high clinical value in the risk assessment of AAD patients with type 2 diabetes.

急性主动脉夹层（AAD）合并2型糖尿病的发病率呈上升趋势，然而，关于其危险因素和预后的研究较少。因此，积极寻求临床一种简便且有效的诊断工具已成为研究的重点。

分析AAD合并2型糖尿病患者危险因素、预后及快速筛查方法。

选取2016年1月—2022年10月宁波市医疗中心李惠利医院收治的168例AAD患者为研究对象，使用主动脉夹层检测风险评分（ADD-RS）量表对患者进行初筛分诊。选用主动脉CT血管造影（CTA）检查结果作为AAD确诊的"金标准"，比较主动脉CTA确诊结果与ADD-RS量表的初筛结果。根据是否合并2型糖尿病分为糖尿病组和非糖尿病组，收集两组的一般资料，采用多因素Logistic回归分析探讨AAD患者合并2型糖尿病的危险因素；比较两组的短期预后及疼痛评分。采用多因素Cox回归分析AAD患者短期预后的影响因素，采用受试者工作特征（ROC）曲线分析ADD-RS量表对AAD合并2型糖尿病的筛查价值。

本研究糖尿病组59例，非糖尿病组109例。多因素Logistic回归分析显示，增龄（OR=1.088，95%CI=1.042~1.136，P<0.001）、BMI≥25 kg/m²（OR=2.000，95%CI=1.421~2.834，P<0.001）、冠心病（OR=7.654，95%CI=1.850~31.677，P=0.005）、高脂血症（OR=4.948，95%CI=1.384~17.681，P=0.014）、左心室射血分数（LVEF）升高（OR=1.199，95%CI=1.109~1.297，P<0.001）是AAD合并2型糖尿病的危险因素。两组患者疼痛评分比较，差异无统计学意义（P>0.05）；两组30 d死亡率分别为3.39%和3.67%，差异无统计学意义（P>0.05）。多因素Cox回归分析显示高血压不是影响AAD患者短期预后的独立因素（HR=0.673，95%CI=0.094~4.791，P>0.05）。糖尿病组的ADD-RS为1（1）分，高于非糖尿病组的1（2）分（Z=-4.640，P<0.001）；糖尿病组的高风险及中风险患者均多于非糖尿病组（Z=2.309，P=0.021）；ADD-RS量表筛查AAD合并2型糖尿病的ROC曲线下面积为0.706（95%CI=0.634~0.779）。

AAD合并2型糖尿病患者的危险因素有年龄增高、BMI≥25 kg/m²、冠心病、高脂血症、LVEF升高，且ADD-RS量表在AAD合并2型糖尿病患者的风险评估中具有较高的临床筛查价值。