大动脉炎累及肺动脉的临床特征、治疗及预后分析  

Analysis of Clinical Features,Treatment and Prognosis in Patients of Takayasu's Arteritis With Pulmonary Artery Stenosis

作　　者：刘亚欣[1] 高凌根[1] 李琳[1] 蒋雄京[1] 王林平[1] 张慧敏[1] 吴海英[1] 宋雷[1] 邹玉宝[1] 关婷[1] 马文君[1] 周宪梁[1] 郑德裕[1] 惠汝太 

机构地区：[1]中国医学科学院北京协和医学院心血管病研究所阜外心血管病医院高血压诊治中心,北京市100037

出　　处：《中国循环杂志》2013年第3期195-198,共4页Chinese Circulation Journal

基　　金：中国医学科学院北京协和医学院中央级公益性科研院所基本科研业务费2011-F09

摘　　要：目的：总结大动脉炎患者累及肺动脉的临床特征、治疗及随访情况。方法：回顾分析我院1992—10至2012—10的连续700例大动脉炎患者中经血管造影证实累及肺动脉的22例患者，并根据其治疗方式的不同分为药物治疗组（n=11）和介入治疗组（n=11），对比两组间临床特征和预后的差异。平均随访（53．54±28．38）月。结果：大动脉炎累及肺动脉患者共22例，男性3例，女性19例，占同期住院大动脉炎患者的3．14％（22／700）；男女比例3：19，年龄22～55（36．3±8．8）岁。临床特征以活动后胸闷、气短为主，其他主要症状和体征包括咳血，颈静脉充盈、P，亢进和无脉症。药物保守治疗11例，共有4例死亡，仅2例改善，其余患者病情进展；8例进行肺动脉球囊成形术后症状均明显改善；3例进行肺动脉内支架置入术，除1例死于肺部感染外其余2例均有效。与药物治疗组患者比较，介入治疗组患者死亡率低（9．1％比36．7％，P〈0．01）。结论：大动脉炎累及肺动脉的患者药物保守治疗效果差，而经皮肺动脉球囊成形术和（或）腔内支架置入术安全有效，可以改善患者预后。Objective： To summarize the clinical features, treatment and prognosis in patients of Takayasu＇s arteritis with pulmonary artery stenosis. Methods： We retrospectively summarized 700 consecutive patients of Takayasu＇s arteritis, and particularly studied those combined with pulmonary artery stenosis who were treated in our hospital from1992 to 2012. The patients were divided into Conservative medication group and Intervention group, n=11 in each group. The clinical features and prognosis were compared between 2 groups. The follow-up period was （53.54 ± 28.38） months. Results： There were 22/700 （3.14%） patients had anglography confirmed pulmonary stenosis, including 3 male and 19 female with the mean age of （36.3 ± 8.8） years. Their main symptoms included dyspnea, short of breath and also hemoptysis, vascular murmur and pulseless. There were 11 patients received conservative medication, 4 of them died, 2 had improved condition and others with progress. 8 patients received pulmonary artery balloon angioplasty and had significantly improved condition; 3 patients underwent pulmonary artery stent implantation, 1 of them died for pulmonary infection, 2 with effective result.The patients in Intervention group showed lower mortality than that in Conservative medication group （9.1% vs. 36.7%）, P〈0.01. Conclusion： Conservative medication was not so effective for treating the patients of Takayasu＇s arteritis with pulmonary stenosis. Percutaneous pulmonary intervention was rather safe and effective for improving the prognosis in those patients.

关 键 词：大动脉炎 肺动脉狭窄 肺动脉高压 经皮介入治疗 

分 类 号：R54[医药卫生—心血管疾病]