126例重庆地区肺高血压患者的诊治现状分析
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摘要
目的分析重庆地区肺高血压(PH)患者的临床特点、经济和营养状况、治疗和预后情况。方法选取2015年8月1日至2018年1月31日该院心内科门诊及住院的PH患者进行横断面调查研究并随访,超声心动图初筛,确诊方式为右心导管。结果 500例患者经超声心动图初筛,126例患者行右心导管后确诊PH。原发疾病最常见的是先天性心脏病[30例(23.81%)]。60例(47.62%)患者有经济困难,80例(63.49%)患者存在营养风险。60例(47.62%)PH患者接受了PH靶向治疗,1年生存率和2年生存率分别为87.90%和84.00%,年龄(OR:8.23,95%CI:2.35～29.49,P=0.001)、PH靶向治疗(OR:0.28,95%CI:0.10～0.77,P=0.013)是PH患者死亡的保护因素。结论重庆地区PH患者的原发疾病主要以先天性心脏病为主,较小的年龄和接受PH靶向治疗是其死亡的保护因素。
Objective To investigate the clinical characters,socioeconomic and nutrition conditions,treatment and prognosis of pulmonary hypertension(PH)in Chongqing.Methods From August 1 st 2015 to January 31 st 2018,PH patients admitted in the hospital were enrolled.PH was screened by echocardiography,the diagnosis was confirmed by right heart catheterization.Results A total of 500 patients were included in the echocardiographic screening,and 126 patients were diagnosed with PH by right heart catheterization.The most common primary disease was congenital heart disease[30 cases(23.81%)],60 cases(47.62%)had financial difficulties,and 80 cases(63.49%)had nutritional risks.Sixty cases(47.62%)with PH received PHtargeted therapy,one-year survival rate and two-year survival rate were 87.90% and 84.00%,respectively.The age(OR:8.23,95%CI:2.35-29.49,P=0.001)and PH-targeted therapy(OR:0.28,95%CI:0.10-0.77,P=0.013)was the protective factors.Conclusion The main etiologies of PH in Chongqing was congenital heart disease,young age and accepting PH-targeted therapy are protective factors for death.
Objective To investigate the clinical characters,socioeconomic and nutrition conditions,treatment and prognosis of pulmonary hypertension(PH)in Chongqing.Methods From August 1 st 2015 to January 31 st 2018,PH patients admitted in the hospital were enrolled.PH was screened by echocardiography,the diagnosis was confirmed by right heart catheterization.Results A total of 500 patients were included in the echocardiographic screening,and 126 patients were diagnosed with PH by right heart catheterization.The most common primary disease was congenital heart disease[30 cases(23.81%)],60 cases(47.62%)had financial difficulties,and 80 cases(63.49%)had nutritional risks.Sixty cases(47.62%)with PH received PHtargeted therapy,one-year survival rate and two-year survival rate were 87.90% and 84.00%,respectively.The age(OR:8.23,95%CI:2.35-29.49,P=0.001)and PH-targeted therapy(OR:0.28,95%CI:0.10-0.77,P=0.013)was the protective factors.Conclusion The main etiologies of PH in Chongqing was congenital heart disease,young age and accepting PH-targeted therapy are protective factors for death.
引文
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[11]WEATHERALD J,HUERTAS A,BOUCLY A,et al.The association between body mass index and obesity with survival in pulmonary arterial hypertension[J].Chest,2018,154(4):872-881.
[12]GENCTOY G,ARIKAN S,ELDEM O.Pulmonary hypertension associates with malnutrition and body composition hemodialysis patients[J].Renal Failure,2014,37(2):273-279.
[13]荆志成.2010年中国肺高血压诊治指南[J].中国医学前沿杂志,2011,3(2):62-81.
[14]LAU E M T,GIANNOULATOU E,CELERMAJER DS,et al.Epidemiology and treatment of pulmonary arterial hypertension[J].Nat Rev Cardiol,2017,14(10):603-614.
[2]JING Z C,XU X Q,HAN Z Y,et al.Registry and survival study in chinese patients with idiopathic and familial pulmonary arterial hypertension[J].Chest,2007,132(2):373-379.
[3]2016年重庆居民人均可支配收入为22 034元[N].[2018-02-08]http://cq.sina.com.cn/city/csgz/2017-03-21/city-ifycnpiu9240972.shtml.
[4]OLSSON K M,DELCROIX M,GHOFRANI H A,et al.Anticoagulation and survival in pulmonary arterial hypertension:results from the Comparative,Prospective Registry of Newly Initiated Therapies for Pulmonary Hypertension(COMPERA)[J].Circulation,2014,129(1):57-65.
[5]BURGER C D,LONG P K,SHAH M R,et al.Characterization of first-time hospitalizations in patients with newly diagnosed pulmonary arterial hypertension in the RE-VEAL registry[J].Chest,2014,146(5):1263-1273.
[6]HARIKRISHNAN S,SANJAY G,ASHISHKUMAR M,et al.Pulmonary hypertension registry of Kerala,India(PRO-KERALA)-clinical characteristics and practice patterns[J].Int J Cardiol,2018,265:212-217.
[7]THIENEMANN F,DZUDIE A,MOCUMBI A O,et al.The causes,treatment,and outcome of pulmonary hypertension in Africa:insights from the Pan African Pulmonary Hypertension Cohort(PAPUCO)Registry[J].Int JCardiol,2016,221:205-211.
[8]STRANGE G,PLAYFORD D,STEWART S,et al.Pulmonary hypertension:prevalence and mortality in the Armadale echocardiography cohort[J].Heart,2012,98(24):1805-1811.
[9]张刚成.先天性心脏病相关肺动脉高压及其诊治进展[J].中国实用内科杂志,2017,37(5):387-390.
[10]WU W H,YANG L,PENG F H,et al.Lower socioeconomic status is associated with worse outcomes in pulmonary arterial hypertension[J].Am J Respir Crit Care Med,2013,187(3):303-310.
[11]WEATHERALD J,HUERTAS A,BOUCLY A,et al.The association between body mass index and obesity with survival in pulmonary arterial hypertension[J].Chest,2018,154(4):872-881.
[12]GENCTOY G,ARIKAN S,ELDEM O.Pulmonary hypertension associates with malnutrition and body composition hemodialysis patients[J].Renal Failure,2014,37(2):273-279.
[13]荆志成.2010年中国肺高血压诊治指南[J].中国医学前沿杂志,2011,3(2):62-81.
[14]LAU E M T,GIANNOULATOU E,CELERMAJER DS,et al.Epidemiology and treatment of pulmonary arterial hypertension[J].Nat Rev Cardiol,2017,14(10):603-614.