Objectives To investigate the clinical manifestation and distribution characteristics of aortopulmonary collateral arteries (APCAs) without cyanotic congenital heart defect, and to analyze the reason of misdiagnosis. Methods The clinical data of 137 APCAs patients without cyanotic congenital heart defect in our hospital from April, 2009 to October, 2010 were reviewed. Clinical characteristics, radiographic findings were analyzed. Results In 137 patients, 99 were combined with pulmonary diseases, 115 cases with heart diseases. Six cases were misdiagnosed in 137 patients. Three cases were misdiagnosed as patent ductus arteriosus. One case was misdiagnosed as cardiomyopathy. One case was misdiagnosed as pulmonary tuberculosis. One case was prolonged the time of antituberculosis therapy because of the lung lesion. There were 130 APCAs (94.9%) originated from descending aorta, five (3.6%) from subclavian artery, one (0.73%) from intercostals artery, one (0.73%) from vertebral artery. Conclusions APCAs exist in the patients without cyanotic congenital heart defect, and APCAs will be narrowed and blocked gradually after birth. However, certain predisposing factors sustain APCAs and increase the pulmonary flow. Patients with APCAs combined with pulmonary disease or heart diseases may be misdiagnosed or diagnosed as a specific disease. Early diagnosis and treatment is critical to prognosis.%目的 探讨不合并紫绀型先天性心脏缺损的主-肺动脉侧枝血管(APCAs)的临床表现、分布规律.方法 回顾分析2009年4月至2016年10月收集的137例不合并紫绀型先天性心脏缺损的APCAs患儿的临床资料.结果 137例APCAs患儿中,男87例、女50例,年龄1小时~17岁3个月,发现APCAs的中位年龄为0.16岁.合并肺部疾病者99例(72.3%),合并心脏疾病者115例(83.9 %).137例患儿中曾误诊为动脉导管未闭3例,误诊为心肌病、肺结核各1例,1例因肺部病变延长抗肺结核治疗时间.APCAs起源于降主动脉130例(94.9 %),起源于锁骨下动脉5例(3.6 %),起源于肋间动脉、椎动脉各1例(0.73 %).结论 APCAs多合并肺部疾病及心脏疾病,可能被误诊.
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