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肺动静脉畸形患者脑并发症的风险因素:一项多中心回顾性队列研究。

Risk factors for cerebral complications in patients with pulmonary arteriovenous malformations: A multicenter retrospective cohort study.

机构信息

Department of Internal Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea.

Chonnam National University Medical School, Gwangju, Republic of Korea.

出版信息

PLoS One. 2022 Dec 1;17(12):e0278610. doi: 10.1371/journal.pone.0278610. eCollection 2022.

Abstract

OBJECTIVE

Pulmonary arteriovenous malformation (PAVM) is a rare pulmonary disease. Although most patients with PAVMs are asymptomatic, cerebral complications associated with PAVMs are often fatal. This study aimed to evaluate the risk factors for cerebral complications in patients with PAVMs.

METHODS

We retrospectively reviewed the medical charts of patients with PAVMs between 2003 and 2021 at two tertiary referral hospitals and one secondary hospital.

RESULTS

Fifty-five patients diagnosed with PAVMs were enrolled in this study. Most patients were female (89.1%), and the median age was 53 years. Thirty patients (54.5%) had incidentally detected PAVMs without symptoms. Twenty-four patients (43.7%) with PAVMs were treated with embolotherapy or surgery. Thirteen patients (23.6%) had cerebral complications. There was no significant difference in the development of cerebral complications according to treatment; however, older age (≥ 65 years) was associated with the development of new cerebral complications in untreated patients with PAVMs (odds ratio, 17.09; 95% confidence interval, 1.16-250.31; P = 0.038).

CONCLUSION

Older age (≥ 65 years) was a risk factor for the development of cerebral complications in patients with PAVMs; therefore, treatment should be considered in older patients with PAVMs.

摘要

目的

肺动静脉畸形(PAVM)是一种罕见的肺部疾病。虽然大多数 PAVM 患者无症状,但与 PAVM 相关的脑并发症通常是致命的。本研究旨在评估 PAVM 患者发生脑并发症的危险因素。

方法

我们回顾性分析了 2003 年至 2021 年间在两家三级转诊医院和一家二级医院就诊的 PAVM 患者的病历。

结果

本研究共纳入 55 例诊断为 PAVM 的患者。大多数患者为女性(89.1%),中位年龄为 53 岁。30 例(54.5%)患者无症状,偶然发现 PAVM。24 例(43.7%)患者接受了栓塞治疗或手术治疗。13 例(23.6%)患者发生了脑并发症。治疗方法与脑并发症的发生无显著差异;然而,未治疗的 PAVM 患者中年龄较大(≥65 岁)与新的脑并发症的发生相关(比值比,17.09;95%置信区间,1.16-250.31;P=0.038)。

结论

年龄较大(≥65 岁)是 PAVM 患者发生脑并发症的危险因素;因此,对于年龄较大的 PAVM 患者应考虑治疗。

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