非支气管性体动脉在咯血患者中的影像分析

The imaging analysis of non-bronchial systemic artery in patients with hemoptysis

目的探讨影响非支气管性体动脉(NBSA)参与咯血供血的相关因素。方法回顾性分析从2015年1月~2016年12月在我院接受诊治的75例咯血患者,采用多层螺旋CT(MSCT)增强扫描,并诊断是否有NBSA参与病灶血供及胸膜增厚,按照有无NBSA、病灶侧是否有胸膜增厚,分别进行分组;询问病史及查阅病历资料,按照与咯血相关的基础病种类及病程进行分组。对各影响NBSA的因素分别进行统计学分析。结果 75例咯血患者中NBSA参与供血26例;有胸膜增厚者42例;支气管扩张(包括肺部感染)38例,肺结核26例,肺部肿瘤4例;肺部血管畸形6例,其他1例;近期病程24例,中期病程19例,长期病程32例。其中胸膜增厚与否对有无NBSA的差异具有统计学意义(P值<0.05),而其他因素对有无NBSA的差异均无统计学意义(P值>0.05)。结论与咯血相关的基础病及其病程对有无NBSA并无明显的影响;而显著的胸膜增厚是产生NBSA供血的重要原因,对指导临床诊治具有重要意义。

Objective To explore the factors related to the non-bronchial systemic artery（NBSA） in the blood supply of hemoptysis. Methods A retrospective analysis of 75 patients with hemoptysis treated in our hospital from January 2015 to December 2016 was conducted in this work. We performed the multi-slice spiral CT（MSCT） scan on those patients and analyzed whether NBSA was involved in blood supply of lesions and pleural thickening. According to whether there were NBSA or the ipsilateral pleural thickening,those patients were divided into different groups. The history and medical records were accessed. Then hemoptysis was grouped according to the related basic types and duration of disease and the factors affecting NBSA were statistically analyzed. Results In those 75 patients with hemoptysis,NBSA participated in blood supply in 26 cases. 42 cases presented with pleural thickening,38 with bronchiectasis（including pulmonary infection）,26 with pulmonary tuberculosis,4 with lung cancer,6 with pulmonary vascular malformation,and 1 with the other disorder. There were 24 cases in short illness course,19 in the middle course,and 32 cases in the long-term duration. The difference between whether there was pleural thickening or not and NBSA had statistically significant（P〈0. 05）,and other factors on the difference between the NBSA had no statistically significant（P〈0. 05）. Conclusion The underlying diseases associated with hemoptysis and the course of disease had no significant effect on NBSA. The significant pleural thickening was an important cause of NBSA blood supply,which was of great significance to guide clinical diagnosis and treatment.