有结核病史的大动脉炎患者临床特点分析

doi:10.3969/j.issn.1006-7795.2019.04.023

首都医科大学学报 ›› 2019, Vol. 40 ›› Issue (4): 621-626.doi: 10.3969/j.issn.1006-7795.2019.04.023

有结核病史的大动脉炎患者临床特点分析

潘丽丽¹, 杜娟¹, 任燕龙², 刘文娴²

1. 首都医科大学附属北京安贞医院风湿免疫科, 北京 100029;
2. 首都医科大学附属北京安贞医院心内科, 北京 100029

收稿日期:2019-02-17 出版日期:2019-07-21 发布日期:2019-07-19
通讯作者: 刘文娴 E-mail:liuwenxian@medmail.com.cn
基金资助:
国家自然科学基金（91739111），北京市自然科学基金（7184205）。

Clinical manifestation in Takayasu arteritis patients with history of tuberculosis

Pan Lili¹, Du Juan¹, Ren Yanlong², Liu Wenxian²

1. Department of Rheumatology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China;
2. Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China

Received:2019-02-17 Online:2019-07-21 Published:2019-07-19
Supported by:
This study was supported by National Natural Science Foundation of China(91739111), Natural Science Foundation of Beijing(7184205).

摘要/Abstract

摘要： 目的分析有结核病史的大动脉炎（Takayasu arteritis，TA）患者临床表现、影像学及实验室检查的特点。方法连续收集住院的TA患者，按照有无结核病史分为2组，比较临床特点、影像学及实验室指标的差异。结果 103例TA患者中，既往有结核病史者19 例，占18.45%，其中肺结核者15例，结核性胸膜炎者2例、支气管内膜结核者1例，结核性腹膜炎者1例。与无结核病史的TA患者比较，有结核病史的TA患者头晕症状降低、外周血中性粒细胞数减少、血清肌酐水平升高、血清补体C3、C4水平降低，差异有统计学意义（P<0.05）。有结核病史者结核分枝杆菌γ扰素释放高于无结核病史者（P<0.05）。有结核病史的TA患者影像学分型以V型最为常见（63.16%），其次是Ⅱb型（15.79%）；有结核病史的TA患者冠状动脉受累的比例为10.53%，肺动脉病变的比例为15.79%，瓣膜病变73.68%，但与无结核病史TA患者比较，差异均无统计学意义（P>0.05）。结论 TA患者既往结核感染比例高，有结核病史的TA患者外周血中性粒细胞数减少、血清肌酐水平升高、血清补体C3、C4水平降低。

关键词: 大动脉炎, 结核, 感染

Abstract: Objective To analyze the clinical manifestations, imaging and laboratory findings of Takayasu arteritis (TA) patients with history of tuberculosis. Methods The hospitalized patients with TA were divided into two groups according to the history of tuberculosis. The differences of clinical characteristics, imaging and laboratory manifestation were compared. Results Among 103 patients with Takayasu arteritis, 19 had history of tuberculosis, including 15 pulmonary tuberculosis, 2 tuberculous pleurisy, 1 endobronchial tuberculosis and 1 tuberculous peritonitis. There was no significant difference in clinical manifestations and laboratory findings between patients with or without history of tuberculosis. In the patients with history of tuberculosis, numano type V was the most common (63.16%), followed by Ⅱb (15.79%). The proportion of coronary artery involvement, pulmonary artery involvement and cardiac valvular lesion in TA patients with history of TB were 10.53%, 15.79% and 73.68%, respectively. Conclusion The rate of previous tuberculosis infection in patients with Takayasu arteritis is high, but there is no significant difference between the clinical features and those without tuberculosis history.

Key words: Takayasu arteritis, tuberculosis, infection

中图分类号:

R543

潘丽丽, 杜娟, 任燕龙, 刘文娴. 有结核病史的大动脉炎患者临床特点分析[J]. 首都医科大学学报, 2019, 40(4): 621-626.

Pan Lili, Du Juan, Ren Yanlong, Liu Wenxian. Clinical manifestation in Takayasu arteritis patients with history of tuberculosis[J]. Journal of Capital Medical University, 2019, 40(4): 621-626.

参考文献 19

[1]	Arend W P,Michel BA,Bloch D A, et al. The American college of rheumatology 1990 criteria for the classification of takayasu arteritis[J]. Arthritis Rheum,1990,33(8):1129-1134.
[2]	Kerr G. Takayasu's arteritis[J]. Curr Opin Rheumatol,1994,6(1):32-38.
[3]	Misra R,Danda D,Rajappa S M,et al. Development and initial validation of the indian takayasu clinical activity score (ITAS2010)[J]. Rheumatology (Oxford),2013,52(10):1795-1801.
[4]	Hata A,Noda M,Moriwaki R,et al. Angiographic findings of takayasu arteritis:new classification[J]. Int J Cardiol,1996,54(Suppl):S155-163.
[5]	Terao C. History of takayasu arteritis and Dr. Mikito Takayasu[J]. Int J Rheum Dis,2014,17(8):931-935.
[6]	全国结核病流行病学抽样调查技术指导组,全国结核病流行病学抽样调查办公室,2010年全国肺结核患病率现况调查[J].中华结核与呼吸杂志,2012,35(9):665-668.
[7]	Lim A Y,Lee G Y,Jang S Y, et al. Comparison of clinical characteristics in patients with Takayasu arteritis with and without concomitant tuberculosis[J]. Heart Vessels,2016,31(8):1277-1284.
[8]	Hahn D,Thomson P D,Kala U,et al. A review of takayasu's arteritis in children in Gauteng,South Africa[J]. Pediatr Nephrol,1998,12(8):668-675.
[9]	Mwipatayi B P,Jeffery P C,Beningfield S J,et al. Takayasu arteritis:clinical features and management:report of 272 cases[J]. ANZ J Surg,2005,75(3):110-117.
[10]	Robles M,Reyes P A. Takayasu's arteritis in mexico:a clinical review of 44 consecutive cases[J]. Clin Exp Rheumatol,1994,12(4):381-388.
[11]	Karadag O,Aksu K,Sahin A, et al. Assessment of latent tuberculosis infection in Takayasu arteritis with tuberculin skin test and quantiferon-TB gold test[J]. Rheumatol Int,2010,30(11):1483-1487.
[12]	Karageorgaki Z T,Bertsias G K,Mavragani C P,et al. Takayasu arteritis:epidemiological,clinical,and immunogenetic features in Greece[J]. Clin Exp Rheumatol,2009,27(Suppl 52):33-39.
[13]	Cong X L,Dai S M,Feng X,et al. Takayasu's arteritis:clinical features and outcomes of 125 patients in China[J]. Clin Rheumatol,2010,29(9):973-981.
[14]	Li J,Sun F,Chen Z,et al. The clinical characteristics of Chinese Takayasu's arteritis patients:a retrospective study of 411 patients over 24 years[J]. Arthritis Res Ther,2017,19(1):107.
[15]	Seko Y,Minota S,Kawasaki A, et al. Perforin-secreting killer cell infiltration and expression of a 65 kD heat-shock protein in aortic tissue of patients with Takayasu's arteritis[J]. J Clin Invest,1994,93(2):750-758.
[16]	Hernandez Pando R,Espitia C,Mancilla R,et al. Takayasu's arteritis. A seroimmunological test of its relationship to mycobacterial infection[J]. Arch Inst Cardiol Mex,1994,64(4):331-337.
[17]	Soto M E,Del Carmen Avila-Casado M,Huesca-Gomez C, et al. Detection of IS6110 and HupB gene sequences of Mycobacterium tuberculosis and bovis in the aortic tissue of patients with Takayasu's arteritis[J]. BMC Infect Dis,2012,12:194.
[18]	Castillo-Martinez D,Amezcua-Guerra L M. Self-reactivity against stress-induced cell molecules:the missing link between Takayasu's arteritis and tuberculosis?[J]. Med Hypotheses,2012,78(4):485-488.
[19]	黄浩, 陈瑜,熊鹏,等.儿童多发性大动脉炎误诊病例辨析[J].临床误诊误治,2018,31(6):28-30.

有结核病史的大动脉炎患者临床特点分析

Clinical manifestation in Takayasu arteritis patients with history of tuberculosis

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献 19

相关文章 15

编辑推荐

Metrics

本文评价

[1]	卓献霞, 赵建康, 曹彬. 呼吸道病原菌在细菌培养阳性组和阴性组中多重定量PCR检测结果的对比分析[J]. 首都医科大学学报, 2022, 43(5): 782-786.
[2]	齐志丽, 林瑾, 董磊, 刘景峰, 段美丽. 重症监护病房血流感染危险因素的Meta分析[J]. 首都医科大学学报, 2021, 42(6): 923-930.
[3]	孟欢, 王爽, 何超男, 韩莹, 潘美晨, 殷商启, 郑梅, 金方方, 王雅杰. SAT法检测人巨细胞病毒pp67 mRNA在人类免疫缺陷病毒合并人巨细胞病毒感染患者临床诊疗中的价值探讨[J]. 首都医科大学学报, 2021, 42(5): 739-746.
[4]	陈彦, 孙英. mRNA疫苗研究进展——2021年拉斯克奖临床医学研究奖[J]. 首都医科大学学报, 2021, 42(5): 893-889.
[5]	张爽, 马向科, 刘思维. 高血压脑出血合并肺部感染危险因素分析及防治[J]. 首都医科大学学报, 2021, 42(4): 660-663.
[6]	王振民, 宫剑. 儿童开颅术后脑脊液外引流与颅内感染的相关性研究[J]. 首都医科大学学报, 2021, 42(2): 269-272.
[7]	段惠娟, 戴广明, 褚洪迁, 杨震, 包城, 何艳萍, 孙照刚. 北京市部分学校肺结核病患者及其密切接触者筛查分析[J]. 首都医科大学学报, 2021, 42(2): 273-279.
[8]	王超宇, 隗明, 刘永哲, 陈云霞, 谷丽. 肺内外隐球菌感染病例的临床特征分析[J]. 首都医科大学学报, 2021, 42(2): 328-333.
[9]	董方, 陈东, 商建峰, 方微, 滕飞, 张睿祺. 门诊消化系统疾病患者幽门螺杆菌感染状况分析[J]. 首都医科大学学报, 2020, 41(3): 372-375.
[10]	乔莉, 曹洋, 袁宏勋, 王瑶. ICU中心静脉导管相关性血流感染的危险因素及病原菌分析[J]. 首都医科大学学报, 2020, 41(1): 125-130.
[11]	王凯丽, 陈世璋. 人类免疫缺陷病毒感染者拔牙围手术期的风险评估和管理[J]. 首都医科大学学报, 2019, 40(5): 754-757.
[12]	善辉, 张鑫, 谷丽, 唐子人, 张小东. 肾移植供体来源性感染的调查及干预[J]. 首都医科大学学报, 2019, 40(5): 764-768.
[13]	张雪芳, 何鑫, 黄文阳, 李卫华, 罗美, 张阳, 王淑珍. 中国女性宫颈高危型HPV感染与阴道微生态关系的Meta分析[J]. 首都医科大学学报, 2018, 39(6): 841-848.
[14]	吕霞丽, 李自慧, 潘丽萍, 贾红彦, 张宗德, 刘洋. 乙酰丙酸－十二烷基硫酸钠对结核分枝杆菌的杀灭作用及其安全性毒理学评价[J]. 首都医科大学学报, 2018, 39(6): 894-899.
[15]	赵凤林, 刘亦婷, 陈杰. 造口旁疝术后感染24例分析[J]. 首都医科大学学报, 2018, 39(5): 732-735.