CT Imaging Features and Its Clinical Significance of Chest before Hemoptysis in Patients with Microscopic Polyangiitis

To investigate the CT features imaging and clinical significance of the chest before hemoptysis in patients with microscopic polyangiitis (MPA). In this study, 48 patients with MPA from May 2018 to December 2019 were selected and confirmed by chest CT, and their clinical data were analyzed retrospectively. According to whether the patients had hemoptysis, patients were divided into two groups. 28 patients in the non-hemoptysis group and 20 patients in the hemoptysis group. The clinical significance of chest CT examination was discussed by comparing the characteristics of chest CT images of the two groups. The clinical manifestations of the two groups were compared, compared with the non-hemoptysis group, the hemoptysis group had more respiratory symptoms, anemia, heart fatigue, shortness of breath and chest pain, these differences have statistical significance (P<0.05); there was no significant difference between the two groups in systemic symptoms and extrapulmonary manifestations (P>0.05). For the two groups of microscopic chest CT manifestations, MPA hemoptysis group patients with consolidation shadows, patchy foci, ground-glass opacity, reticular shadows and other lesions were significantly higher than those of non-hemoptysis group, which was statistically significant (P<0.05); there was no significant difference in CT findings between the two groups, such as nodular shadow, interlobular septal thickening, cavity, bronchiectasis, mediastinal lymph node enlargement, pulmonary bullae, pleural effusion and fibrous streak shadow (P>0.05). The indexes of erythrocyte sedimentation rate, sCRP and white blood cells in hemoptysis group were higher than those in control group, the difference was statistically significant (P<0.05). In the hemoptysis group, 8 patients died in 3 months follow-up, the mortality rate was 40.00%; There was no death in the non-hemoptysis group. Comparison of mortality between the two groups, the difference between the two groups was significant (P<0.05). There was no significant difference between the two groups in the treatment of maintenance hemodialysis (P<0.05). The mortality of patients with MPA hemoptysis is very high, the inflammation index of patients is obviously increased, and they have serious symptoms such as heart fatigue, shortness of breath, expectoration, cough, chest pain, etc.; the chest CT imaging examination shows that the patients with MPA hemoptysis have reticular shadows, ground-glass opacity, consolidation shadows, patchy foci, etc., which can be diagnosed in early stage according to the above characteristics, providing basis for clinical treatment and reducing the mortality.