原发性干燥综合征患者合并肺动脉高压危险因素分析  

Analysis of the Risk Factors of Pulmonary Arterial Hypertension in Patients with Primary Sj?gren's Syndrome

作　　者：李智腾 范观止 段培青 张榕 肖卫国[1] LI Zhiteng;FAN Guanzhi;DUAN Peiqing;ZHANG Rong;XIAO Weiguo(Department of Rheumatology,The First Hospital,China Medical University,Shenyang 110001,China)

机构地区：[1]中国医科大学附属第一医院风湿免疫科,沈阳110001

出　　处：《中国医科大学学报》2018年第5期420-425,共6页Journal of China Medical University

基　　金：辽宁省科学技术计划(2012225097)

摘　　要：目的 分析原发性干燥综合征(pSS)合并肺动脉高压(PAH)患者的临床特征,探讨pSS患者发生PAH的危险因素。方法 回顾性分析16例pSS合并PAH患者(pSS-PAH组)的临床资料、实验室相关指标、超声心动图等,与同期诊断的60例无PAH的pSS患者(pSS-non-PAH组)进行比较。结果 pSS-PAH组与pSS-non-PAH组比较,乳酸脱氢酶[(349.86±253.30)U/L vs(217.44±165.17)U/L]、谷草转氨酶[(41.50±34.37)U/L vs(24.61±18.68)U/L]、血清尿酸浓度[(374.20±128.26)μmol/L vs(292.13±244.64)μmol/L]、磷离子浓度[(1.30±0.13)mmol/L vs(1.16±0.18)mmol/L]、右心室内径[(28.69±9.33)mm vs(18.58±2.10)mm]、肺动脉内径[(28.19±5.09)mm vs(22.0±2.29)mm]均明显升高(P<0.01,P<0.05,P<0.05,P<0.01,P<0.01,P<0.01);而甲状腺激素T3水平[(3.24±0.90)pmol/L vs(3.97±0.68)pmol/L)]、血清镁离子浓度[(0.82±0.09)mmol/L vs(0.88±0.07)mmol/L]、左心室舒张末期内径[(40.50±6.70)mm vs(45.07±3.78)mm]、每搏量[(40.75±6.90)mL vs(51.32±11.57)mL]、左心室收缩末期容积[(21.94±5.90)mL vs(29.51±7.89)mL]、左心室舒张末期容积[(62.69±11.79)mL vs(80.76±17.93)mL]较pSS-non-PAH组降低(P<0.01,P<0.05,P<0.05,P<0.05,P<0.01,P<0.01)。logistic回归分析发现甲状腺素T3浓度降低、血清镁离子浓度降低、血清磷离子浓度升高是pSS合并PAH的危险因素(OR=0.251,P<0.05;OR=0,P<0.05;OR=2.088,P<0.05)。结论 甲状腺素T3浓度降低、血清镁离子浓度降低、血清磷离子浓度升高或许是提示pSS患者发生PAH的血清学指标。Objective To investigate the clinical characteristics and risk factors of primary S¨jogren’s syndrome-associated pulmonary arterial hypertension(pSS-PAH).Methods The clinical data of 16 patients with pSS-PAH and 60 patients with pSS without PAH(pSSnon-PAH)were collected retrospectively.The t test,Mann-Whitney U test,chi-square test,and logistic regression analysis were used for statistical analysis of the laboratory index,echocardiographic data,and other related data.Results Compared with the pSS-non-PAH group,the pSS-PAH group had evidently increased lactate dehydrogenase(349.86±253.30 U/L vs 217.44±165.17 U/L),aspartate aminotransferase(41.50±34.37 U/L vs 24.61±18.68 U/L),serum uric acid(374.20±128.26μmol/L vs 292.13±244.64μmol/L),serum phosphorus(P)concentrations(1.30±0.13 mmol/L vs 1.16±0.18 mmol/L)right ventricular diameter(28.69±9.33 mm vs 18.58±2.10 mm),and pulmonary artery diameter(28.19±5.09 mm vs 22.0±2.29 mm;P<0.01,<0.05,<0.05,<0.01,<0.01,and<0.01,respectively).However,the thyroid hormone T3(3.24±0.90 pmol/L vs 3.97±0.68 pmol/L)and serum magnesium(Mg)concentrations(0.82±0.09 mmol/L vs 0.88±0.07 mmol/L),left ventricular end-diastolic diameter(40.50±6.70 mm vs 45.07±3.78 mm),stroke volume(40.75±6.90 mL vs 51.32±11.57 mL),left ventricular end-systolic volume(21.94±5.90 mL vs 29.51±7.89 mL),and left ventricular end-diastolic volume(62.69±11.79 mL vs 80.76±17.93 mL)were lower in the pSS-PAH group than in the pSS-non-PAH group(P<0.01,<0.05,<0.05,<0.05,<0.01,and<0.01,respectively).The logistic regression analysis revealed that reduced thyroid hormone T3 and serum Mg concentrations,and elevated serum P concentrations were the risk factors of pSS complicated with PAH(OR=0.251,P<0.05;OR=0,P<0.05;and OR=2.088,P<0.05).Conclusion The reduced thyroid hormone T3 and serum Mg concentrations,and elevated serum P concentration may be the serological indicators to predict PAH in patients with pSS.

关 键 词：干燥综合征 肺动脉高压 甲状腺素T3 镁 磷 

分 类 号：R593.2[医药卫生—内科学]