结核毁损肺合并原发肺动脉血栓形成的临床特征  

The clinical characteristics of patients with tuberculosis-destroyed lung and in-situ pulmonary artery thrombosis

作　　者：池琼 郑纪阳 戴新建 张抱一 黄阳 CHI Qiong;ZNENG Jiyang;DAI Xinjian;ZHANG Baoyi;HUANG Yang(Department of Pulmonary and Critical Care Medicine,Wenzhou Central Hospital,Wenzhou 325000,China)

机构地区：[1]温州市中心医院呼吸与危重症医学科,浙江温州325000

出　　处：《温州医科大学学报》2021年第6期483-486,490,共5页Journal of Wenzhou Medical University

摘　　要：目的:分析结核毁损肺(TDL)合并原发肺动脉血栓形成(PAT)患者的临床特征及预后。方法:回顾性收集2015年6月至2020年5月在温州市中心医院呼吸与危重症医学科住院的TDL患者,根据有无合并PAT,分为TDL合并PAT组与单纯TDL组,收集患者基本信息、结核病史、影像学信息、肺动脉收缩压(SPAP)、血气分析等资料,比较两组患者临床特点和预后。结果:与单纯TDL组比较,TDL合并PAT组多肺叶毁损较多,肺泡-动脉氧分压差较高,SPAP>50 mmHg(中、重度肺动脉高压)的比例较高(均P<0.05)。TDL合并PAT组有1例患者死亡,单纯TDL组患者均健在。结论:TDL患者,尤其是多肺叶毁损、中重度肺动脉高压的患者,应警惕合并PAT。Objective:To summarize and analyze the clinical characteristics and prognosis of patients with tuberculosis-destroyed lung(TDL)and in-situ pulmonary artery thrombosis(PAT).Methods:Patients with TDL who were hospitalized in Wenzhou Central Hospital from June 2015 to May 2020 were analyzed retrospectively.They were divided as TDL with PAT group and TDL group,according to whether they were complicated with PAT.Data on demographic characteristics,tuberculosis history,imaging information,systolic pulmonary artery pressure(SPAP)and blood gas analysis were collected.Results:Compared with TDL group,patients complicated with PAT had more damaged lobe lesions(P<0.05).ABG showed higher alveolar-arterial oxygen partial pressure difference.The rate of SPAP>50 mmHg(moderate and severe pulmonary hypertension)in patients complicated with PAT was 100%(6/6),which was significantly higher(P<0.05)than TDL group19%(4/21).One patient died in TDL with PAT group,wihile none died in TDL group.Conclusion:Patients with TDL who have multiple lobes damaged and moderate to severe pulmonary hypertension should be alert to be complicated with PAT.

关 键 词：结核 毁损肺 原发肺动脉血栓形成 肺动脉高压 

分 类 号：R563[医药卫生—呼吸系统] R621[医药卫生—内科学]