背景:支气管动脉栓塞(BAE)过程中存在全身动脉-肺循环分流(SPS),已被推断为复发的潜在危险因素。这项研究的目的是揭示SPS对BAE后非癌症相关咯血复发的影响。
方法:在本研究中,比较了从2015年1月至2020年12月因非癌相关性咯血而接受BAE的134例SPS患者(SPS存在组)和192例无SPS患者(SPS缺失组)。使用四种不同的Cox比例风险回归模型来阐明SPSs对BAE后咯血复发的影响。
结果:在39.8个月的中位随访时间内,75例(23.0%)患者复发,包括SPS存在组中的51(38.1%)和SPS不存在组中的24(12.5%)。1个月,1年,2年,SPS存在和SPS缺失组3年和5年无咯血生存率为91.8%,79.7%,70.6%,62.3%,52.6%和97.9%,94.7%,89.0%,87.1%,82.3%,分别(P<0.001)。四个模型中SPS的调整风险比为3.37[95%置信区间(CI),2.07-5.47,模型1中P<0.001],1.96(95%CI,1.11-3.49,模型2中P=0.021),2.29(95%CI,1.34-3.92,模型3中P=0.002),和2.39(95%CI,1.44-3.97,模型4中P=0.001)。
结论:BAE期间SPS的存在增加了BAE后非癌症相关咯血的复发概率。
BACKGROUND: The presence of systemic artery-pulmonary circulation shunt (SPS) during the bronchial arterial embolization (BAE) procedure, has been inferred to be a potential risk factor for recurrence. The aim of this
study is to reveal the impact of SPS on the recurrence of noncancer-related hemoptysis after BAE.
METHODS: In this
study, 134 patients with SPS (SPS-present group) and 192 patients without SPS (SPS-absent group) who underwent BAE for noncancer-related hemoptysis from January 2015 to December 2020 were compared. Four different Cox proportional hazards regression models were used to clarify the impact of SPSs on hemoptysis recurrence after BAE.
RESULTS: During the median follow-up time of 39.8 months, recurrence occurred in 75 (23.0%) patients, including 51 (38.1%) in the SPS-present group and 24 (12.5%) in the SPS-absent group. The 1-month, 1-year, 2-year, 3-year and 5-year hemoptysis-free survival rates in the SPS-present and SPS-absent groups were 91.8%, 79.7%, 70.6%, 62.3%, and 52.6% and 97.9%, 94.7%, 89.0%, 87.1%, and 82.3%, respectively (P < 0.001). The adjusted hazard ratios of SPSs in the four models were 3.37 [95% confidence intervals (CI), 2.07-5.47, P < 0.001 in model 1], 1.96 (95% CI, 1.11-3.49, P = 0.021 in model 2), 2.29 (95% CI, 1.34-3.92, P = 0.002 in model 3), and 2.39 (95% CI, 1.44-3.97, P = 0.001 in model 4).
CONCLUSIONS: The presence of SPS during BAE increases the recurrence probability of noncancer-related hemoptysis after BAE.