成人肺动脉高压疾病特征的多中心临床研究  

Multicenter study of disease attributes in adult patients with pulmonary hypertension

作　　者：董琳[1] 何建国[1] 柳志红[1] 卢献灵[1] 曾伟杰[1] 孙云娟[1] 倪新海[1] 顾晴[1] 赵智慧[1] 程显声[1] 熊长明 

机构地区：[1]北京协和医学院阜外心血管病医院肺血管病诊治中心,北京100037

出　　处：《中华医学杂志》2012年第16期1087-1090,共4页National Medical Journal of China

基　　金：国家科技支撑计划课题

摘　　要：目的了解成人肺动脉高压患者的人口学、血流动力学和临床特征。方法自2007年5月至2010年10月，在全国31个临床中心纳入经右心导管确诊的成人肺动脉高压患者，收集所有患者的人口学特征、临床特征以及血流动力学指标，了解不同类型肺动脉高压患者的人口学特征，并且将所有患者分为世界卫生组织（WHO）肺动脉高压功能Ⅰ／Ⅱ和Ⅲ／Ⅳ级两组，比较两组患者的临床及血流动力学特征。结果本研究共纳入551例患者，其中动脉型肺动脉高压（PAH）和慢性血栓栓塞性肺动脉高压（CTEPH）患者分别有487例和64例。患者平均年龄（35±12）岁，女性患者386例（70．1％）。体质指数为（21±4）kg／m2。最常见症状为乏力（421例，76．4％）和呼吸困难（398例，72．2％），最常见体征为P2亢进（510例，92．6％）。WHO肺动脉高压功能分级为Ⅱ级的患者有325例（59．0％），Ⅲ级的患者有213例（38．6％）。6min步行距离和Borg呼吸困难评分分别为（352±91）m和3．0（2．0—4．0）。497例（90．2％）患者心电图表现出右室肥厚。右心导管测右房压为（9±6）mmHg（1mmHg=0．133kPa），肺动脉平均压（674-20）mmHg，心指数（2．7±1．2）L·min-1·m-2，肺血管阻力（1496±783）dyn·sec·cm-5。结论我国成人肺动脉高压多累及青壮年女性，体质指数偏低。就诊时患者病情较差，血流动力学状况不佳。患者血流动力学的损害与6MWD及心功能分级相关。Objeetive To understand the demographic, hemodynamic and clinical features of adult patients with pulmonary hypertension （PH） in China. Methods Between May 2007 and October 2010, a total of 551 adult PH patients were recruited from 31 clinical centers all over China. All fulfilled the traditional hemodynamic criteria diagnosed through right heart catheterization （RHC）. The relevant data of demographic, clinical and hemodynamie features of all patients, analyzed the similarities and differences of demographic characteristics between different subtypes. They were divided into 2 groups： WHO functional class I / ]l and Ill/IV. And their hemodynamic and clinical features were compared. Results There were 165 males and 386 females with a mean age of （35 ± 12） years. The mean body mass index （BMI） was （21 ± 4） kg/m2. There were pulmonary arterial hypertension （ PAH, n = 487） and chronic thromboembolie pulmonary hypertension （CTEPH, n =64）. Fatigue （421,76. 4% ） and dyspnea （398, 72. 2% ） were the most common symptoms; Physical examination revealed such a common sign as an accentuated pulmonic second sound （ P2 ） in 510 patients （92. 6% ）. Over half （325, 59.0% ） of them were of WHO functional class 11 and 213 （38. 6% ） patients functional class Ⅲ. The 6-minute walking distance （6MWD） and Borg dyspnea score were （352 ±91 ） m and 3.0 （2. 0 ±4. 0） respectively. ECG of 497（90. 2% ）patients showed fight ventfieular hypertrophy. Mean fight atrial pressure was （9 ± 6） mm Hg （ 1 mm Hg = 0. 133 kPa）, pulmonary arterial pressure （67 ±20） mm Hg, cardiac index （2. 7± 1.2） L · min-1· m-2 and pulmonary vascular resistance （1496 ± 783 ） dyn ·see· cm-s Condusions Young females with a low BMI are predominantly affected by PH. Severe functional and hemodynamic compromises often appear onpresentation. And hemodynamic impairment is correlated with 6MWD and WHO functional class.

关 键 词：高血压 肺性 成年人 疾病特征 

分 类 号：R543.2[医药卫生—心血管疾病]