摘要
目的:探讨纤维素性纵隔炎(FM)的临床特点及超声心动图的评估价值。方法:回顾分析2015年9月~2020年8月间于中日友好医院确诊并接受超声心动图检查的34例FM患者(男5例,女29例,平均年龄67.7±8.5岁)资料,总结其临床特点及心脏超声表现。结果:本组患者25例(73.5%)与结核感染相关,主要症状为慢性反复发作性咳嗽、咳痰、气短等。部分患者支气管镜及病理检查提示支气管色素沉着纤维化,影像学检查可见支气管及肺动静脉狭窄和/或扩张,通气/灌注“不匹配”。超声心动图提示肺动脉增宽13例(38.2%),肺动静脉狭窄2例(5.9%),右心增大11例(32.4%),存在不同程度三尖瓣反流23例(67.6%),肺动脉压力升高20例(58.8%)。结论:FM好发于老年女性,与结核感染密切相关,常合并慢性阻塞性肺病,可继发肺动脉高压及肺源性心脏病,超声心动图特点包括肺动静脉受累、不同程度的肺动脉压力升高及右心重构。
Objective:To investigate the clinical characteristics and the value of echocardiography in fibrosing mediastinitis(FM).Methods:From September 2015 to August 2020,34 FM patients(5 males,29 females,average age 67.7±8.5 years)who underwent echocardiography in China-Japan Friendship Hospital were retrospectively studied.Clinical manifestations,endoscopic features,radiological characteristics,pulmonary ventilation/perfusion(V/Q)SPECT,right heart catheter,pulmonary artery angiography,and echocardiography were analyzed.Results:There are 25 cases(73.5%)in this group were related to tuberculosis infection.The main clinical symptoms of this reccurrent and chronic disease were cough,expectoration,shortness of breath,etc.Some of the patients were found to be with bronchial anthracofibrosis by bronchoscopy and biopsy. Imaging examination showed stenosis and/or expansion of bilateral or unilateral bronchial lumens,similarly of pulmonary arteries or veins.Pulmonary V/Q SPECT imaging showed“mismatch”.According to the results of echocardiography,13 cases(38.2%) showed main pulmonary arterial and/or bronchial dilation,while 2 cases(5.9%) were found pulmonary arterial or veinous stenosis;right atrial or right ventricular enlargement were in 11 cases(32.4%).There were 23 cases(67.6%)of tricuspid regurgitation.Elevation of pulmonary arterial systolic pressure was found in20 cases(58.8%).Conclusion:FM mostly attacks aged women and it is mostly correlated with tuberculosis. It may be combined with chronic obstructive pulmonary diseases,and the severe cases can result in pulmonary arterial hypertension and pulmonary heart disease.The main features of FM in echocardiography include pulmonary arterial and veinous dilation or stenosis,various elevation of pulmonary artery pressure,and right heart remodeling.
作者
王嘉莉
李爱莉
翟亚楠
叶小钧
刘敏
张晓岩
高倩
WANG Jia-li;LI Ai-li;ZHAI Ya-nan(Department of Cardiology,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《中日友好医院学报》
CAS
2022年第3期131-135,147,F0002,共7页
Journal of China-Japan Friendship Hospital
基金
首都卫生发展科研专项(2020-2-4063)
国家临床重点专科建设项目(2020-QTL-009)。
关键词
纤维素性纵隔炎
肺动脉压
超声心动图
fibrosing mediastinitis
pulmonary arterial pressure
echocardiography
