Department of Respiratory and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China; Beijing Institute of Respiratory Medicine, Beijing 100020, PR China; Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China.
Department of Interventional Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing 100020, PR China.
Int J Cardiol. 2023 Jun 15;381:88-93. doi: 10.1016/j.ijcard.2023.03.026. Epub 2023 Mar 11.
The aim of this study was to investigate the clinical characteristics of patients between active and inactive Takayasu's arteritis with pulmonary artery involvement (PTA) and to identify better markers of disease activity in these patients.
Sixty-four PTA patients in Beijing Chao-yang hospital (2011 to 2021) were included. According to National Institutes of Health criteria, 29 patients were in active stage and 35 were in inactive stage. Their medical records were collected and analyzed.
Compared with inactive group, patients in active group were younger. More patients in active stage presented fever (41.38% vs 5.71%), chest pain (55.17% vs 20%), increased C-reactive protein (2.91 vs 0.46 mg/L), erythrocyte sedimentation rate (35.0 vs 9 mm/h), and platelet count (291 vs 221 × 10/L). Pulmonary artery wall thickening was more common in active group (51.72% vs 11.43%). These parameters were restored after treatment. The incidence of pulmonary hypertension was comparable between groups (34.48% vs 51.43%), but patients in active group had lower pulmonary vascular resistance (PVR) (361.0 vs 891.0 dyn·s·cm) and higher cardiac index (2.76 ± 0.72 vs 2.01 ± 0.58 L/min/m). On multivariate logistic regression analysis, chest pain [odds ratio (OR) 9.37, 95%CI (1.98-44.38), P = 0.005], increased platelet count (>242.5 × 10/L) [OR 9.03, 95%CI (2.10-38.87), P = 0.003] and pulmonary artery wall thickening [OR 7.08, 95%CI (1.44-34.89), P = 0.016] were independently associated with disease activity.
Chest pain, increased platelet count, and pulmonary artery wall thickening are potential new indicators of disease activity in PTA. Patients in active stage may have lower PVR and better right heart function.
本研究旨在探讨活动性与非活动性大动脉炎合并肺动脉受累（PTA）患者的临床特征，并确定这些患者中更好的疾病活动标志物。
纳入北京朝阳医院 2011 年至 2021 年收治的 64 例 PTA 患者。根据美国国立卫生研究院标准，29 例患者处于活动期，35 例处于非活动期。收集并分析其病历资料。
与非活动组相比，活动组患者更年轻。更多的活动期患者有发热（41.38% vs 5.71%）、胸痛（55.17% vs 20%）、C 反应蛋白升高（2.91 vs 0.46mg/L）、红细胞沉降率升高（35.0 vs 9mm/h）和血小板计数升高（291 vs 221×10/L）。活动组中更常见肺动脉壁增厚（51.72% vs 11.43%）。这些参数在治疗后得到恢复。两组肺动脉高压的发生率相似（34.48% vs 51.43%），但活动组患者的肺动脉阻力（PVR）较低（361.0 vs 891.0dyn·s·cm），心指数较高（2.76±0.72 vs 2.01±0.58L/min/m）。多变量 logistic 回归分析显示，胸痛[比值比（OR）9.37，95%可信区间（1.98-44.38），P=0.005]、血小板计数升高（>242.5×10/L）[OR 9.03，95%可信区间（2.10-38.87），P=0.003]和肺动脉壁增厚[OR 7.08，95%可信区间（1.44-34.89），P=0.016]与疾病活动独立相关。
胸痛、血小板计数升高和肺动脉壁增厚可能是 PTA 疾病活动的潜在新指标。活动期患者可能具有较低的 PVR 和更好的右心功能。
