肋间后动脉与咯血的相关性分析  

Correlation between posterior intercostal arterial blood supply and hemoptysis

作　　者：钱元新[1] 伍筱梅[1] 赖清[1] 梁荣光[1] 任医民[1] 陈志远[1] 宋玉全[1] 林海波[1] 

机构地区：[1]广州医学院第一附属医院放射科,510120

出　　处：《介入放射学杂志》2012年第9期731-734,共4页Journal of Interventional Radiology

基　　金：广东省科技计划项目(2010B031600144)

摘　　要：目的探讨肋间后动脉作为非支气管性体动脉(NBSA)参与咯血的相关大素,为介入治疗提供指导。方法回顾分析219例咯血患者的临床资料及多层螺旋CT(MSCT)、DSA等影像资料。观察肋间后动脉参与咯血的发生率,形成体肺循环分流(BPS)的情况,以及与胸膜增厚及基础疾病的相关性;同时分析基础疾病与胸膜增厚的相关性。结果 219例患者中,44例(20.1%)患者共87条肋间后动脉作为NBSA参与咯恤,其巾65条(74.7%)合并BPS。44例巾36例(81.8%)伴有胸膜增厚。39例肺结核患者中21例(53.8%)伴有肋间后动脉参与咯血,其中13例肺结核合并肺毁损者中10例(76.9%)伴有肋间后动脉参与咯血。肋间后动脉参与咯血、合并BPS与胸膜增厚相关(P<0.05)。肋间后动脉参与咯血、胸膜增厚在不同基础疾病中的差异有统计学意义(P<0.05)。结论肋间后动脉是重要的咯血相关体动脉;参与肺咯血与胸膜增厚密切相关,且多数伴有BPS;基础疾病以肺结核尤其是合并肺毁损患者最常见。Objective To investigate the correlation between posterior intercostal arterial blood supply and hemoptysis in order to improve the therapeutic results of interventional treatment. Methods The clinical data and imaging materials （multi-slice helical CT scan and DSA） of 219 patients with hemoptysis were retrospectively analyzed. The occurrence of posterior intercostal artery involving in the lesion＇s blood supply, the formation of broncho-pulmonary shunt （BPS）, the pleural thickening and underlying diseases were determined. The relationships between each other of the factors were analyzed. Statistical analysis was performed by using X2 test. Results In 44 patients a total of 87 posterior intercostal arterial collaterals, regarded as non- bronchial systemic artery （NBSA）, were involved in hemoptysis. Of the 87 posterior intercostal arteries, coexisting BPS was found in 65 （74.7%）. Of the 44 patients, pleural thickening was seen in 36 （81.8%）. Among the 39 patients who had pulmonary tuberculosis, posterior intercostal artery participating in hemoptysis was found in 21 （53.8%）. Of 13 patients who had pulmonary tuberculosis compli- cated by destroyed lung, posterior intercostal artery participating in hemoptysis was detected in 10 （76.9%）. The correlation between posterior intercostal arterial collaterals and pleural thickening, as well as between BPS and pleural thickening was statistically significant （P 〈 0.05）. The differences in posterior intercostal artery participation in hemoptysis as well as in the pleural thickening between different underlying diseases were statistically significant （P 〈 0.05）. Conclusion The posterior intercostal artery is an important systemic artery related to the blood supply of hemoptysis. Its participation in hemoptysis is strongly related to the pleural thickening, and in most cases it is accompanied with BPS. Pulmonary tuberculosis, especially accompanied with severely destroyed lung, is the most common underlying cause to induce the posteri

关 键 词：咯血 肋间后动脉 体-肺循环分流 胸膜增厚 

分 类 号：R56[医药卫生—呼吸系统]