Zhou Jingya, Li Jing, Wang Yi, Yang Yunjiao, Zhao Jiuliang, Li Mengtao, Pang Haiyu, Wang Tingyu, Chen Yuexin, Tian Xinping, Zeng Xiaofeng, Zheng Yuehong
Department of Medical Records, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
WHO Family of International Classifications Collaborating Center of China, Beijing, China.
Front Cardiovasc Med. 2023 Mar 16;10:1099144. doi: 10.3389/fcvm.2023.1099144. eCollection 2023.
We aimed to investigate the demographic characteristics, vascular involvement, angiographic patterns, complications, and associations of these variables in a large sample of TAK patients at a national referral center in China.
The medical records of TAK patients discharged from 2008 to 2020 were retrieved from the hospital discharge database using ICD-10 codes. Demographic data, vascular lesions, Numano classifications and complications were collected and analyzed.
The median age at onset was 25 years in 852 TAK patients (670 female, 182 male). Compared with the females, the male patients were more likely to have type IV and were more likely to have iliac (24.7% vs. 10.0%) and renal artery (62.7% vs. 53.9%) involvement. They also had a higher prevalence of systemic hypertension (62.1% vs. 42.4%), renal dysfunction (12.6% vs. 7.8%) and aortic aneurysm (AA) (8.2% vs. 3.6%). The childhood-onset group was more likely to have involvement of the abdominal aorta (68.4% vs. 52.1%), renal artery (69.0% vs. 51.8%) and superior mesenteric artery (41.5% vs. 28.5%), and they were more likely to have type IV, V and hypertension than the adult-onset group. After adjusting for sex and age at onset, the patients with type II were associated with an increased risk of cardiac dysfunction (II vs. I: OR = 5.42; II vs. IV: OR = 2.63) and pulmonary hypertension (II vs. I: OR = 4.78; II vs. IV: OR = 3.95) compared with those with types I and IV. Valvular abnormalities (61.0%) were observed to be most prevalent in patients with type IIa. The patients with Type III were associated with a higher risk of aortic aneurysm (23.3%) than the patients with types IV (OR = 11.00) and V (OR = 5.98). The patients with types III and IV were more commonly complicated with systemic hypertension than the patients with types I, II and V. < 0.05 in all of the above comparisons.
Sex, adult/childhood presentation and Numano angiographic type were significantly associated with differences in phenotypic manifestations, especially cardiopulmonary abnormalities, systemic hypertension, renal dysfunction and aortic aneurysm.
我们旨在调查中国一家国家级转诊中心大量大动脉炎（TAK）患者的人口统计学特征、血管受累情况、血管造影模式、并发症以及这些变量之间的关联。
使用国际疾病分类第十版（ICD - 10）编码从医院出院数据库中检索2008年至2020年出院的TAK患者的病历。收集并分析人口统计学数据、血管病变、野间分类和并发症。
852例TAK患者（670例女性，182例男性）的发病年龄中位数为25岁。与女性相比，男性患者更易出现IV型病变，且更易累及髂动脉（24.7%对10.0%）和肾动脉（62.7%对53.9%）。他们还具有更高的系统性高血压患病率（62.1%对42.4%）、肾功能不全患病率（12.6%对7.8%）和主动脉瘤（AA）患病率（8.2%对3.6%）。儿童期发病组更易累及腹主动脉（68.4%对52.1%）、肾动脉（69.0%对51.8%）和肠系膜上动脉（41.5%对28.5%），且与成人发病组相比，更易出现IV型、V型病变和高血压。在调整发病时的性别和年龄后，与I型和IV型患者相比，II型患者发生心脏功能障碍（II型对I型：比值比[OR]=5.42；II型对IV型：OR = 2.63）和肺动脉高压（II型对I型：OR = 4.78；II型对IV型：OR = 3.95）的风险增加。观察到瓣膜异常（61.0%）在IIa型患者中最为普遍。III型患者发生主动脉瘤的风险（23.3%）高于IV型（OR = 11.00）和V型患者（OR = 5.98）。III型和IV型患者比I型、II型和V型患者更常并发系统性高血压。上述所有比较中P<0.05。
性别、成人/儿童发病表现和野间血管造影类型与表型表现的差异显著相关，尤其是心肺异常、系统性高血压、肾功能不全和主动脉瘤。
