大动脉炎累及肺动脉患者的CT表现及临床相关性分析  

CT findings and clinical features of Takayasu′s arteritis with pulmonary artery involvement

作　　者：吕蓉[1] 于长路[1] 李剑[2] 文娣娣[2] 郑敏文[2] 

机构地区：[1]天津市第三中心医院放射科,天津市肝胆疾病研究所,天津市人工细胞重点实验室,卫生部人工细胞工程技术研究中心,300170 [2]第四军医大学西京医院放射科

出　　处：《中华医学杂志》2017年第23期1796-1800,共5页National Medical Journal of China

摘　　要：目的探讨大动脉炎（TA）累及肺动脉患者的CT征象及其临床相关性分析。方法回顾分析西京医院2007年11月至2016年11月诊断TA并肺动脉受累的患者35例，男6例、女29例，年龄15～52（28±9）岁，作为研究组（TA＋P组），同时搜集该院2015年1月至2016年11月诊断TA但未累及肺动脉的患者40例，男5例、女35例，年龄7～67（28±12）岁，作为对照组（TA组），用t检验、χ^2检验和秩和检验比较两组患者临床、实验室资料、肺动脉及右心测量数据，并分析TA＋P组肺动脉受累的CT征象。结果TA＋P组患者较TA组多出现气短、气喘（54.3%比10.0%）、咳嗽（31.4%比12.5%）、心悸（11.4%比0）等症状（均P〈0.05），但两组间病变活动性及病程时间比较差异无统计学意义（均P〉0.05）。TA＋P组35例患者共312个肺动脉节段受累，CT表现以管腔狭窄最多见（35例，211节段），其次为闭塞（14例，94节段）；双侧（23例，217节段）及多支（34例，311节段）同时受累多见。TA＋P组肺动脉收缩压、主肺动脉管径、右心房、右心室宽径均〉TA组（均P〈0.05）。结论大动脉炎累及肺动脉有一定的CT特点，其与病变的活动性及病程时间无关，该类患者常合并肺动脉高压，并出现相应的影像学及临床表现。Objective To explore the CT findings of the Takayasu′s arteritis （TA）with pulmonary artery （PA） involvement and its clinical significance.Methods A total of 35 patients with TA involving the PA in Xijing Hospital from November 2007 to November 2016, 6 male cases, 29 female cases, the age was 15-52 （28±9） years old, were retrospectively collected and included in the study group （TA＋ P group）, meanwhile 40 patients with TA but not involving the pulmonary artery in this hospital from January 2015 to November 2016 were collected as control group, 5 male cases, 35 female cases, the age was 7-67 （28±12） years old.The clinical and laboratory data, the pulmonary artery and right heart measurement data of the two groups were compared by using t test, χ^2 test , and rank sum test.The CT signs of pulmonary artery involvement in the TA＋ P group were analyzed.Results TA＋ P group patients had shortness of breath, wheezing（54.3% vs 10.0%）, cough（31.4% vs 12.5%）and palpitations（11.4% vs 0）mostly, and there were statistical difference between TA＋ P group and TA group （all P〈0.05）, However, there was no difference between the two groups in the activity and duration of disease （all P〉0.05）. In TA＋ P group, a total of 312 pulmonary artery segments were involved in 35 patients.The lumen stenosis of PA was more common（35 cases, 211 segments）, followed by occlusion（14 cases, 94 segments）, bilateral PA （23 cases, 217 segments） and multiple branches of PA involvement（34 cases, 311 segments） were more common.The PA systolic pressure, the diameter of main pulmonary artery, right atrium and right ventricular width of the TA＋ P group patients were significantly higher than those of the TA group （all P〈0.05）.Conclusions There are some CT certain characteristics in TA pulmonary arterial involvement, and they are not related to the activity and duration of the disease.Most patients with PA involvement present pulmonary hypertension and a series of special clinica

关 键 词：体层摄影术 X线计算机 肺动脉 TAKAYASU动脉炎 

分 类 号：R543.5[医药卫生—心血管疾病] R816.2[医药卫生—内科学]