Departments of Rheumatology and Immunology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
Departments of Rheumatology, Beijing Chaoyang Hospital, Capital Medical University, #8 Gong-Ti South Road, Chaoyang District, Beijing, 100020, China.
Arthritis Res Ther. 2023 Jan 14;25(1):9. doi: 10.1186/s13075-022-02987-4.
To investigate the clinical characteristics and the site of pulmonary involvement in Takayasu arteritis (TAK) patients with pulmonary artery involvement (PAI).
We retrospectively investigated data of 141 TAK patients. The clinical and image data of the patients with and without PAI were analyzed and compared. The patients were followed up. The major outcome was all-cause mortality. The minor outcome was exacerbation or new occurrence of PAI, which leads to disease progression events.
For the 141 TAK patients considered, PAI was detected in 65 (46.1%) patients. TAK patients with PAI had a significantly higher cumulative incidence of events than those without PAI (P < 0.001). The frequencies of the following were significantly higher in TAK with PAI than those in TAK without PAI: disease duration [median 96 months (IQR: 24-174) vs. median 42 months (IQR: 6-120); P = 0.012], hemoptysis (10.8% vs. 1.32%; P = 0.040), oppression in the chest (40.0% vs. 21.1%; P = 0.014), fever (23.1% vs. 9.21%; P = 0.024), Mycobacterium tuberculosis infection (21.5% vs. 6.57%; P = 0.010), pulmonary hypertension (PAH) (21.5% vs. 2.6%; P < 0.001), pulmonary infarction (41.5% vs. 0%; P < 0.001), and hypoxemia (18.5% vs. 1.3%; P < 0.001). Multivariate logistic regression analysis of data of TAK patients with symptom presentation showed that oppression in the chest (OR: 2.304; 95% CI: 1.024-5.183; P = 0.044) and thoracic aorta involvement (OR: 2.819; 95% CI: 1.165-6.833; P = 0.022) were associated with PAI. The cluster analysis performed for data of TAK patients with PAI revealed that the cluster characterized as the upper lobe of the right lung (Cluster1) had the worst prognosis.
In TAK, PAI is associated with thoracic aorta involvement. In TAK patients with PAI, the involvement of the upper lobe of the right lung is characterized with the worst prognosis.
探讨特发性大动脉炎（TAK）合并肺动脉受累（PAI）患者的临床特征及肺部受累部位。
我们回顾性调查了 141 例 TAK 患者的数据。分析比较了合并和不合并 PAI 的患者的临床和影像学数据。对患者进行了随访。主要结局为全因死亡率。次要结局为 PAI 加重或新发，导致疾病进展事件。
在考虑的 141 例 TAK 患者中，65 例（46.1%）患者检测到 PAI。与无 PAI 相比，TAK 合并 PAI 的患者具有更高的累积事件发生率（P < 0.001）。TAK 合并 PAI 的患者中以下情况的频率明显高于 TAK 无 PAI 的患者：疾病持续时间[中位数 96 个月（IQR：24-174）比中位数 42 个月（IQR：6-120）；P = 0.012]、咯血（10.8%比 1.32%；P = 0.040）、胸闷（40.0%比 21.1%；P = 0.014）、发热（23.1%比 9.21%；P = 0.024）、结核分枝杆菌感染（21.5%比 6.57%；P = 0.010）、肺动脉高压（PAH）（21.5%比 2.6%；P < 0.001）、肺梗死（41.5%比 0%；P < 0.001）和低氧血症（18.5%比 1.3%；P < 0.001）。TAK 患者症状表现的多变量逻辑回归分析显示，胸闷（OR：2.304；95%CI：1.024-5.183；P = 0.044）和胸主动脉受累（OR：2.819；95%CI：1.165-6.833；P = 0.022）与 PAI 相关。对 TAK 合并 PAI 患者的数据进行聚类分析显示，以右肺上叶为特征的聚类（Cluster1）预后最差。
在 TAK 中，PAI 与胸主动脉受累有关。在 TAK 合并 PAI 的患者中，右肺上叶受累的特征是预后最差。
