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大动脉炎患者非血管肺部表现的患病率:一项回顾性多中心土耳其队列研究。

The prevalence of non-vascular pulmonary manifestations in Takayasu's Arteritis patients: A Retrospective multi-centred Turkish cohort study.

机构信息

Department of Internal Medicine, Division of Rheumatology, School of Medicine, Kocaeli University, Kocaeli, Turkey.

Department of Internal Medicine, Division of Rheumatology, School of Medicine, Marmara University, Istanbul, Turkey.

出版信息

Scand J Rheumatol. 2022 Jul;51(4):304-308. doi: 10.1080/03009742.2021.1972535. Epub 2021 Oct 13.

Abstract

OBJECTIVES

Takayasu's arteritis (TAK) is a rare vasculitis characterized by inflammation of intermediate- to large-size arteries. Although pulmonary artery involvement (PAI) is an expected finding in some TAK patients, data on non-vascular pulmonary involvement (NVPI) are limited. We aimed to investigate the frequency of NVPI, including parenchymal infiltration, nodules/cavities, pleural effusion, and haemorrhage, in TAK.

METHOD

We assembled a retrospective cohort of TAK patients from nine tertiary centres in Turkey. The demographics and clinical characteristics of patients were extracted from medical records and the imaging findings were evaluated for pulmonary manifestations.

RESULTS

As of January 2021, 319 TAK patients (female/male 276/43; mean age 42.4 ± 13.5 years) were recruited. Eighty-two patients had cough and/or dyspnoea and four had haemoptysis as pulmonary symptoms. On computed tomography assessment, the overall frequency of NVPI was 7.2%; parenchymal infiltrations were present in 10 (3.1%), pleural effusion in eight (2.5%), nodules/cavities in six (1.9%), and pulmonary haemorrhage in four patients (1.3%). In the whole cohort, 10.3% of patients had pulmonary artery hypertension (PAH) and 5.6% had PAI. Among patients with PAH or PAI, the overall frequency of NVPI was significantly higher than in the rest of the group.

CONCLUSIONS

In this TAK cohort from Turkey, we observed NVPI in 7.2% of patients, with parenchymal infiltrations being the most common, followed by pleural effusion. Notably, NVPI was more frequent in patients with PAH or PAI. Although not as common as PAI, NVPI should be kept in mind, especially in TAK patients with PAH or PAI.

摘要

目的

Takayasu 动脉炎(TAK)是一种罕见的血管炎,其特征为中等至大血管的炎症。虽然肺动脉受累(PAI)在一些 TAK 患者中是预期的发现,但关于非血管性肺受累(NVPI)的数据有限。我们旨在研究 TAK 中 NVPI 的频率,包括实质浸润、结节/空洞、胸腔积液和出血。

方法

我们从土耳其的 9 个三级中心组建了一个 TAK 患者的回顾性队列。从病历中提取患者的人口统计学和临床特征,并评估影像学表现以评估肺部表现。

结果

截至 2021 年 1 月,共纳入 319 名 TAK 患者(女/男 276/43;平均年龄 42.4±13.5 岁)。82 名患者有咳嗽和/或呼吸困难,4 名患者有咯血等肺部症状。在计算机断层扫描评估中,NVPI 的总体发生率为 7.2%;实质浸润 10 例(3.1%),胸腔积液 8 例(2.5%),结节/空洞 6 例(1.9%),肺出血 4 例(1.3%)。在整个队列中,10.3%的患者有肺动脉高压(PAH),5.6%有 PAI。在有 PAH 或 PAI 的患者中,NVPI 的总体发生率明显高于其他组。

结论

在土耳其的这个 TAK 队列中,我们观察到 7.2%的患者有 NVPI,最常见的是实质浸润,其次是胸腔积液。值得注意的是,PAH 或 PAI 患者的 NVPI 更为常见。尽管不如 PAI 常见,但应注意到 NVPI,尤其是在有 PAH 或 PAI 的 TAK 患者中。

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