Cha Seung-Ick, Choi Keum-Ju, Shin Kyung-Min, Lim Jae-Kwang, Yoo Seung-Soo, Lee Jaehee, Lee Shin-Yup, Kim Chang-Ho, Park Jae-Yong
aDepartment of Internal Medicine bDepartment of Radiology, Kyungpook National University School of Medicine, Daegu, South Korea.
Blood Coagul Fibrinolysis. 2015 Dec;26(8):903-7. doi: 10.1097/MBC.0000000000000343.
Little is known regarding the clinical features and course of in-situ pulmonary artery thrombosis (PAT). The aim of the present study was to investigate the clinical characteristics of PAT. Patients with PAT were retrospectively identified from a tertiary referral center in South Korea. A control group consisted of patients with pulmonary embolism in whom the right or left pulmonary artery was the largest pulmonary embolism-involved site. We compared various clinical parameters between the two groups. Of the 23 PAT patients, the most common underlying condition was tuberculosis-destroyed lung [11 (47.8%)], followed by pulmonary artery stump after lobectomy or pneumonectomy [7 (30.4%)]. In all patients except one, PAT was located in the right or left pulmonary artery. Computed tomography scans demonstrated that clots were completely or partially resolved less frequently in the PAT group than in the control group [4 (25%) versus 62 (90%); P < 0.001]. In the PAT group, three of the seven patients (43%) who had undergone anticoagulation therapy exhibited improvement, and one of the nine patients (11%) who had not received anticoagulation therapy experienced improvement; however, the difference was not significant. Tuberculosis-destroyed lung was the most common underlying condition in Korean PAT patients, followed by pulmonary artery stump after lung resection. The clots in patients with PAT were mostly located in the right or left pulmonary artery, and clot resolution was less frequent in the PAT group compared to the pulmonary embolism group.
关于原位肺动脉血栓形成(PAT)的临床特征和病程,目前所知甚少。本研究的目的是调查PAT的临床特征。从韩国一家三级转诊中心回顾性地确定了PAT患者。对照组由右或左肺动脉为最大血栓累及部位的肺栓塞患者组成。我们比较了两组之间的各种临床参数。在23例PAT患者中,最常见的基础疾病是结核毁损肺[11例(47.8%)],其次是肺叶切除或全肺切除术后的肺动脉残端[7例(30.4%)]。除1例患者外,所有患者的PAT均位于右或左肺动脉。计算机断层扫描显示,PAT组血栓完全或部分溶解的频率低于对照组[4例(25%)对62例(90%);P<0.001]。在PAT组中,接受抗凝治疗的7例患者中有3例(43%)病情改善,未接受抗凝治疗的9例患者中有1例(11%)病情改善;然而,差异无统计学意义。结核毁损肺是韩国PAT患者最常见的基础疾病,其次是肺切除术后的肺动脉残端。PAT患者的血栓大多位于右或左肺动脉,与肺栓塞组相比,PAT组血栓溶解的频率较低。