不同性别多发性大动脉炎患者心脏损害的临床特点  

Clinical features of cardiac manifestations in patients with Takayasu＇s arteritis in different genders

作　　者：万瑾[1] 潘丽丽[1] 慈维苹[1] 廖华[1] 杨春[2] 王天[1] 

机构地区：[1]首都医科大学附属北京安贞医院风湿免疫科北京市心肺血管疾病研究所,100029 [2]首都医科大学基础医学院,北京100069

出　　处：《中国医药》2017年第9期1310-1313,共4页China Medicine

基　　金：国家自然科学基金（81400361）;首都医科大学附属北京安贞医院院长科技发展基金（15P07）

摘　　要：目的探讨不同性别多发性大动脉炎（TA）患者心脏损害的临床特点。方法回顾性分析2004年1月至2015年1月于首都医科大学附属北京安贞医院住院治疗的82例TA患者的临床资料。根据影像学检查评估心脏损害情况，记录TA合并心脏损害患者一般资料、临床表现、实验室检查、血管受累、临床分型情况以及影像学检查结果。结果82例TA患者中合并心脏损害者52例，占63．4％（52／82）。52例TA合并心脏损害患者中，男6例，女46例。男性与女性的起病年龄及起病到确诊时间比较，差异均无统计学意义（均P〉0．05）。男性双上肢血压差≥10mmHg（1mmHg=0．133kPa）比例低于女性[1／6比73．9％（34／46）]，差异有统计学意义（P〈0.05）。男性C反应蛋白升高比例高于女性[6／6比50．O％（23／46）]，差异有统计学意义（P〈0．05）。男性红细胞沉降率增大比例与女性比较，差异无统计学意义（P〈0．05）。男性左锁骨下动脉累及发生率明显低于女性[0／6比69．6％（32／46）]，差异有统计学意义（P〈0．05）。男性临床分型与女性比较，差异无统计学意义（P〉0．05）。男性左心室射血分数水平明显低于女性[（54±15）％比（64±9）％]，左心室舒张功能降低发生率高于女性[6／6比32．6％（15／46）]，差异均有统计学意义（均P〈0．05）。男性心肌病变发生率高于女性[2／6比4．3％（2／46）]，差异有统计学意义（P〈0．05）。结论男性TA患者心脏损害易出现心肌病变及左心室舒张功能减低，女性患者则多表现为左锁骨下动脉受累．Objective To investigate clinical features of cardiac damage in patients with Takayasu＇s Arteritis （TA） in different genders. Methods Clinical data of 82 patients with TA from January 2004 to January 2015 in Beijing Anzhen Hospital, Capital Medical University were analyzed retrospectively. Cardiac impairment was assessed by imaging examination; general data, clinical manifestations, laboratory indicators, vascular involvements, clinical classification and echocardiographic findings were analyzed in TA patients with cardiac damage. Results There were 63.4% （52/82） of TA complicated with cardiac damage, including 6 males and 46 females. The onset age and the duration between onset and diagnosis had no significant differences between male and female （ P 〉 0.05 ）. The proportion of upper limbs blood pressure difference 〉i 10 mmHg in male was significantly lower than that in female[ 1/6 vs 73. 9% （34/46） ] （P 〈0. 05）. The proportion of C-reactive protein elevation in male was significantly higher than that in female [ 6/6 vs 50. 0% （23/46） ] （P 〈 0.05 ）. The propor- tion of erythrocyte sedimentation rate elevation had no significant difference between male and female （P 〉 0. 05 ）. The incidence of left subclavian artery stenosis or occlusion in male was significantly lower than that in female [ 0/6 vs 69.6% （32/46） ] （P 〈 0. 05 ）. The clinical classification had no significant difference between male and female（P 〉 0.05）. The left ventrieular ejection fraction in male was lower and the incidence of left ventricular diastolic dysfunction was higher than those in female [ （54 ± 15 ）% vs （64 ± 9 ）%, 6/6 vs 32. 6% （15/46） （P 〈 0. 05）. The incidence of myocardial lesions in male was significantly higher than that in female [ 2/6 vs 4. 3% （2/46） ] （P 〈 0. 05 ）. Conclusion Cardiac damage in male patients with TA mainly manifests myocardial lesions and left ventricular diastolic dysfunction; it in female patients mainly manifests left su

关 键 词：多发性大动脉炎 心脏损害 性别 

分 类 号：R543.5[医药卫生—心血管疾病]