男性大动脉炎患者的临床特点分析  

Analysis of clinical features of male patients with Takayasu arteritis

作　　者：何艳茹 党爱民[1] 程楠[1] 吕纳强[1] 张炜[1] He Yanru;Dang Aimin;Cheng Nan;Lyu Naqiang;Zhang Wei(Department of Special Care Center,Fuwai Hospital,National Clinical Research Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing 100037,China)

机构地区：[1]中国医学科学院北京协和医学院国家心血管疾病临床医学研究中心阜外医院特需医疗诊治中心

出　　处：《中国心血管杂志》2019年第4期314-318,共5页Chinese Journal of Cardiovascular Medicine

摘　　要：目的寻找男性大动脉炎患者的临床特点,以指导其个体化诊治。方法回顾性分析2014—2016年阜外医院239例大动脉炎患者,其中男性46例,女性193例,比较临床特点的性别差异。结果男女性大动脉炎患者起病年龄无明显差异[25(16,38)岁比26(19,37)岁,Z=-0.528,P=0.60];与女性相比,男性多以血压升高为首发主诉(60.9%比35.8%,χ^2=9.719,P<0.01),双侧肢体血压不对称、颈动脉及锁骨下动脉杂音等体征较少(均为P<0.05)。男性累及胸主动脉及其分支、升主动脉、颈总动脉、左锁骨下动脉的比例均明显低于女性(均为P<0.05),但累及右肾动脉的比例明显高于女性(50.0%比30.1%,χ^2=6.597,P=0.01)。男性的动脉瘤形成和肾功能不全发生率均明显高于女性(17.4%比5.2%,χ^2=7.952,P<0.01;19.6%比5.2%,χ^2=10.502,P<0.01)。结论男性大动脉炎患者多以血压升高为首发症状,多累及右肾动脉,易合并肾功能不全和动脉瘤形成。Objective To analyze the clinical characteristics of male patients with Takayasu arteritis(TA)and guide their individualized diagnosis and treatment.Methods A retrospective analysis of 239 patients with TA were performed in Fuwai Hospital between 2014 and 2016,including 46 males and 193 females.Their clinical features were compared.Results There was no significant difference in onset age between male and female patients[25(16,38)years vs.26(19,37)years,Z=-0.528,P=0.60].Compared with female patients,hypertension was more common as chief complain in male patients(60.9%vs.35.8%,χ^2=9.719,P<0.01).Bilateral asymmetric blood pressure and carotid artery,subclavian artery murmur were less common in males than in females(all P<0.05).Male patients had higher proportion of involvement of right renal artery(50.0%vs.30.1%,χ ^2=6.597,P=0.01)and lower frequency of involvement of thoracic aorta and its branches,ascending aorta,common carotid artery,and left subclavian artery than females(all P<0.05).Furthermore,aneurysm formation and renal dysfunction incidence were significantly higher in males than that in females(17.4%vs.5.2%,χ ^2=7.952,P<0.01;19.6%vs.5.2%,χ ^2=10.502,P<0.01).Conclusions Hypertension is more common to be found in male TA patients as the first symptom.Right renal artery is frequently to be involved,renal insufficiency and aneurysm formation are easy to be complicated in male patients.

关 键 词：TAKAYASU动脉炎 男性 性别 临床特点 

分 类 号：R54[医药卫生—心血管疾病]