大动脉炎累及肺动脉的临床分析  

The analysis of the clinical records diagnosed as Takayasu’s arteritis with pulmonary vascular involvement

作　　者：窦静波 龚娟妮[1] 马展鸿[3] 邝土光[1] 杨媛华[1] 

机构地区：[1]首都医科大学附属北京朝阳医院呼吸与危重症医学科北京呼吸疾病研究所,100020 [2]北京市普仁医院呼吸内科 [3]首都医科大学附属北京朝阳医院放射科,100020

出　　处：《中华结核和呼吸杂志》2016年第8期603-607,共5页Chinese Journal of Tuberculosis and Respiratory Diseases

基　　金：国家“十二五”科技支撑计划课题（2013BAI09B00）

摘　　要：目的探讨大动脉炎累及肺动脉的临床特点、影像学征象及误诊、治疗情况，加深对大动脉炎累及肺动脉的认识。方法回顾性分析北京朝阳医院2004年1月至2014年12月间收治的大动脉炎累及肺动脉患者的临床资料。结果10年间朝阳医院共收治大动脉炎患者90例，累及肺动脉患者33例，占36.7%，其中单独累及肺动脉12例，占13.3%；单纯累及右肺动脉21例，累及双侧肺动脉12例；临床表现最常见的是喘憋（23例，69.7%），其次为咯血（19例，57.6%）；主要体征为可闻及血管杂音（23例，69.7%），胸腔积液（8例，24.2%），双上肢血压不等（4例，12.1%）。确诊时间1个月～10余年不等，确诊前21例患者被误诊，误诊率为63.6%。结论 大动脉炎累及肺动脉并不少见，临床表现无特异性，误诊率高，应提高对大动脉炎的认识，认真体格检查，降低误诊率。ObjectiveTo enhance the understanding of Takayasu’s arteritis with pulmonary vascular involvement through the analyses on clinical features, imaging findings, misdiagnoses and treatments.MethodsA retrospective study was conducted to analyze the clinical records of patients diagnosed as Takayasu’s arteritis with pulmonary vascular involvement admitted to Beijing Chaoyang Hospital from January 2004 to December 2014. ResultsIn recent 10 years, there were 90 patients diagnosed as Takayasu’s arteritis in Beijing Chaoyang Hospital, 33 of them were involved with pulmonary arterial, which account for 36.7%, while 12 cases were involved with pulmonary arteries alone, which account for 13.3% of all. Among the 33 patients, dyspnea （23 cases, 69.7%） was the most common symptom, followed by hemoptysis （19 cases, 57.6%） and Vascular murmur （23 cases, 69.7%）, pleural effusion （8 cases, 24.2%）, unequal blood pressure of upper limbs （4 cases, 12.1%） were the main signs. The diagnostic time varied significantly, from 1 month to 10 years. 21 patients were misdiagnosed and the misdiagnosis rate was 63.6%. ConclusionTakayasu’s arteritis with pulmonary vascular involvement is not rare. The clinical manifestation of Takayasu’s arteritis is unspecific and misdiagnosis rate is relatively high. Therefore, we should raise awareness of Takayasu’s arteritis and detailed clinical examination will be helpful to reduce the misdiagnosis rate.

关 键 词：大动脉炎 肺动脉狭窄 肺动脉高压 误诊 

分 类 号：R543[医药卫生—心血管疾病]