Lyu R, Yu C L, Zhang X, Hu W J, Li J, Wen D D, Zheng M W
Department of Radiology, the Third Central Hospital of Tianjin, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Tianjin Institute of Hepatobiliary Disease, Tianjin 300170, China.
Department of Radiology, the First Hospital of Air Force Medical University, Xi'an, Shaanxi 710032, China.
Zhonghua Jie He He Hu Xi Za Zhi. 2021 May 12;44(5):462-467. doi: 10.3760/cma.j.cn112147-20200510-00576.
Takayasu's arteritis involving the pulmonary artery (PTA) is uncommon, and those with pulmonary hypertension (PH) are even rarer. This study investigated the clinical features and CT findings in PTA patients with PH. A total of 40 PTA patients were retrospective selected in the First Hospital of Air Force Medical University from January 2008 to January 2018. There were 14 PTA patients with PH, including 3 male and 11 female cases, aged from 18 to 53 (29.7±9.4) years, as the study group (PTA+PH group). There were 26 PTA patients without PH, including 4 males and 22 females, aged 15-52 (28.9±8.5) years, as the control group (PTA group). The or test, test of two independent samples and Mann-Whitney rank sum test were used to compare the general information, symptoms, signs, laboratory examination data, right ventricular and pulmonary artery measurement data, and pulmonary artery CT findings between the two groups. Compared with the PTA group, the patients in the PTA+PH group had longer disease duration, fewer active cases, more shortness of breath, chest distress and lower limb edema, lower blood oxygen partial pressure (PaO) and lower ESR (all <0.05). The width of right atrium and right ventricle in PTA+PH group was greater than that in PTA group (all 0.05). The main CT findings of the involved pulmonary artery included lumen stenosis (39 cases, 97.5%), lumen occlusion (16 cases, 40%), wall thickening (9 cases, 22.5%), and lumen dilation (2 cases, 5.0%). Patients in the PTA+PH group had less wall thickening and mild lumen stenosis (<50%), more severe lumen stenosis (≥50%) and occlusion than those in the PTA group (all <0.05). PTA patients with PH showed certain characteristics in clinical, laboratory and CT findings, which may be correlated to the stage of the disease duration, the severity, and the prognosis.
累及肺动脉的大动脉炎（PTA）并不常见，而合并肺动脉高压（PH）的患者更为罕见。本研究调查了合并PH的PTA患者的临床特征和CT表现。2008年1月至2018年1月期间，空军军医大学第一附属医院共回顾性选取了40例PTA患者。其中有14例合并PH的PTA患者，包括3例男性和11例女性，年龄18至53岁（29.7±9.4岁），作为研究组（PTA+PH组）。有26例不合并PH的PTA患者，包括4例男性和22例女性，年龄15至52岁（28.9±8.5岁），作为对照组（PTA组）。采用卡方检验、两独立样本t检验和Mann-Whitney秩和检验比较两组的一般信息、症状、体征、实验室检查数据、右心室和肺动脉测量数据以及肺动脉CT表现。与PTA组相比，PTA+PH组患者病程更长，活动期病例更少，气短、胸闷和下肢水肿更多，血氧分压（PaO）更低，血沉更低（均P<0.05）。PTA+PH组右心房和右心室的宽度大于PTA组（均P<0.05）。受累肺动脉的主要CT表现包括管腔狭窄（39例，97.5%）、管腔闭塞（16例，40%）、管壁增厚（9例，22.5%）和管腔扩张（2例，5.0%）。PTA+PH组患者管壁增厚较少，管腔狭窄较轻（<50%），管腔重度狭窄（≥50%）和闭塞比PTA组更多（均P<0.05）。合并PH的PTA患者在临床、实验室和CT表现上呈现一定特点，可能与病程阶段、病情严重程度及预后相关。
