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目的:分析累及肺血管的多发性大动脉炎(Takayasu’s arteritis,TA)的临床特点,以提高临床诊断水平。方法 :回顾分析2005―2012年曾诊断为肺血栓栓塞症,因抗凝治疗效果不佳收治于北京朝阳医院呼吸与危重症医学科的TA患者的临床资料。结果 :TA患者共9例,临床表现主要包括发热(5例)、乏力(3例)、盗汗(2例)、头晕/晕厥(5例)、手足冷/肢体麻木(2例);呼吸系统症状主要为活动后加重的呼吸困难(8例)、咳嗽(5例)、胸痛(5例)和咯血(5例)。CT肺血管检查可见病变多样,范围比较广泛,主要表现为血管狭窄、闭塞和扩张。结论 :累及肺血管的TA临床表现多样,容易误诊。CT肺血管检查可以较好的反应病变特点和范围。激素和免疫抑制剂仍是治疗活动期TA的重要方法。
Objective: To analyze the clinical features of Takayasu’s arteritis (TA) involving the pulmonary vessels in order to improve the clinical diagnosis. Methods: The clinical data of patients with TA who had been diagnosed as pulmonary thromboembolism from 2005 to 2012 and were admitted to Department of Respiratory and Critical Care Medicine at Beijing Chaoyang Hospital were retrospectively analyzed. Results: A total of 9 patients with TA included clinical manifestations of fever (5 cases), weakness (3 cases), night sweats (2 cases), dizziness / fainting (5 cases), hand / foot cold / limb numbness Symptoms were mainly dyspnea (8 cases), cough (5 cases), chest pain (5 cases) and hemoptysis (5 cases) after the activity. CT pulmonary vascular examination showed diverse lesions, a wider range, mainly for vascular stenosis, occlusion and expansion. Conclusion: The clinical manifestations of TA involving pulmonary vascular diversity, easy to misdiagnosis. CT pulmonary vascular examination can better reflect the characteristics and scope of the lesion. Hormones and immunosuppressive agents are still important ways to treat active TA.