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
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.
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abstractsObjective:To enhance the understanding of Takayasu' s arteritis with pulmonary vascular involvement through the analyses on clinical features,imaging findings,misdiagnoses and treatments.Methods A 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.Results In 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%.Conclusion Takayasu'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.
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