上葉起源喀血の特徴：31例の患者に基づく分析
Ya-Jing Zhao1, Hai-Tao Yan1, Jin-Xing Zhang1
1Department of Interventional Radiology, The First Affiliated Hospital with Nanjing Medical University, Nanjing, China.
Journal of thoracic disease
|January 12, 2026
まとめ
再発性出血患者における上葉起源喀血（ULOH）の治療には、気管支動脈塞栓術（BAE）が有効である。本研究では、BAEが肺構造および機能の完全な回復をもたらし、再発がないことを示した。
科学分野:
- インターベンショナルラジオロジー; 呼吸器内科; 血管イメージング
背景:
- 喀血、すなわち血を伴う咳は、様々な呼吸器疾患に関連している。; 上葉起源喀血（ULOH）は、保存的治療および初期検査が正常であるにもかかわらず、再発性のエピソードを呈する。; 気管支動脈塞栓術（BAE）は主要な治療法であり、コンピューテッドトモグラフィー血管造影（CTA）はその計画を支援する。
研究 の 目的:
- ULOH患者の臨床的特徴を定義すること。; ULOH患者におけるBAEの有効性と転帰を評価すること。; ULOHに関連する特異的な画像所見を特定すること。
主な方法:
- 治療再発後にBAEを受けた31例のULOH患者のコホートを対象とした。; 人口統計、臨床歴、画像検査（CTA、DECT）、BAEの詳細、および転帰を含むデータを収集した。; 術後の呼吸リハビリテーションおよび肺機能評価のための二重エネルギーCT（DECT）を実施した。
主要な成果:
- 本研究には31例の患者（男性90.3％、重喫煙者71.0％）、中央値年齢49歳が含まれた。; CTAは上葉に限局した出血と正常な気管支動脈径（<2.0 mm）を示した。; 血管造影検査では、両側肺尖部に左右対称の体肺シャント（SPS）が認められた。; BAEは病変の完全な消失をもたらし、24ヶ月の追跡期間中に再発はなかった。
結論:
- ULOH患者は、正常な気管支動脈径および血管造影検査における左右対称の肺尖部SPSを示す。; BAEはULOHに対して非常に効果的な治療法であり、完全な構造的および機能的回復をもたらす。; 本コホートでは、BAEおよびリハビリテーション後の喀血再発は観察されなかった。
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