目的 探讨肺动脉直径在结缔组织病相关间质性肺炎(connective tissue disease-associated interstital lang disease，CTD-ILD)预后评估中的临床应用价值。方法 回顾性分析2012-2023年郑州大学第一附属医院住院的389例CTD-ILD患者的一般临床资料，并经胸部CT测定平均肺动脉宽度(mean pulmonary artery，MPA)、对应升主动脉宽度(AAo)及肺动脉和主动脉宽度比值(PA/AAo)，并对其预后进行了随访。应用Cox比例风险模型对影响CTD-ILD预后的因素进行分析。结果 Cox单因素分析显示，年龄、性别、血沉(erythrocyte sedi-mentation rate，ESR)、一氧化碳弥散功能(diffusing capacity of the lung for carbon monoxide，DLCO)、平均肺动脉(MPA)直径和CTD-ILD的全因死亡率相关。多因素分析结果进一步显示，MPA、年龄、性别、血沉和CTD-ILD全因死亡率有关。受试者工作特征曲线(ROC)分析了 MPA直径对CTD-ILD预后预测的界值为30。65 mm。Kaplan-Meier(KM)预后分析进一步揭示，在CTD-ILD患者中，MPA≥30。65 mm患者5年生存率低于MPA＜30。65 mm患者。结论 CT测量的肺动脉宽度对评估CTD-ILD预后具有潜在临床应用价值。
Pulmonary artery diameter as a prognostic indicator in connective tissue disease associated with interstitial lung disease
Objective Aim To investigate the role of the MPA diameter in predicting the outcomes of connective tissue dis-ease-associated interstital,lang disease(CTD-ILD)patients.Methods Totally 389 Chinese CTD-ILD patients from 2012 to 2023 were enrolled in our study.We retrospectively reviewed the imaging data and clinical data of the patients,and their clinical outcomes were also assessed.Results During the observational period,52 patients were followed to death.Cox univa-riate proportional hazard analysis showed that age,gender,erythrocyte sedimentation rate(ESR),diffusing capacity of the lung for carbon monoxide(DLCO),mean pulmonary artery(MPA)diameter were related to all-cause mortality in CTD-ILD patients.In Cox multivariate proportional hazard analysis,MPA,age,gender,ESR were predictors of all-cause mortali-ty in patients with CTD-ILD.Kaplan-Meier analysis showed that 5-year survival rate was significantly lower in patients with MPA ≥30.65 mm compared with those with MPA＜30.65mm.Conclusion In CTD-ILD patients,Pulmonary artery(PA)accessed by CT scan might represent a useful tool to predict their survival outcomes.
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