超声心动图测量肺血管阻力对肺高血压的预后价值  

Prognostic Value of Pulmonary Vascular Resistance by Echocardiography in Patients with High Probability of Pulmonary Hypertension

作　　者：胡敏[1] 魏言芳 孙晓霞[1] 程珊珊 冯芳芳[1] 张佑成 程文[2] Hu Min;Wei Yanfang;Sun Xiaoxia;Cheng Shanshan;Feng Fangfang;Zhang Youcheng;Cheng Wen(Department of Echocardiogram and Electrocardiogram,Huangshan City People’s Hospital,Huangshan Anhui 245000,China;Department of Respiratory and Critical Care Medicine,Huangshan City People’s Hospital,Huangshan Anhui 245000,China)

机构地区：[1]黄山市人民医院心电功能检查科,安徽省黄山市245000 [2]黄山市人民医院呼吸与危重症医学科,安徽省黄山市245000

出　　处：《中国超声医学杂志》2023年第8期879-882,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究超声心动图测量的肺血管阻力(PVRe)对肺高血压高度可能(PHe)患者的预后价值。方法本前瞻性观察研究纳入了常规超声心动图检查中发现的PHe住院患者,使用三尖瓣反流峰速与右心室流出道血流速度时间积分比值估测PVRe,随访全因死亡或多器官功能衰竭持续恶化放弃治疗等终点事件。结果598例患者,年龄中位数76(IQR 69~83)岁,男315例(52.7%)。中位随访时间92(42~156)天,达到终点事件35例,其PVRe[3.2(2.4~5.1)WU]高于其他病例[2.8(2.2~3.6)WU,P=0.026]。多元Cox回归分析发现,PVRe>5 WU是无终点事件生存时间缩短的独立危险因素,以PVRe≤2 WU为参比HR=6.59(95%CI:1.73~25.06,P=0.006)。结论PVRe>5 WU的PHe患者生存时间缩短,可优化风险分层。Objective To determine the prognostic value of pulmonary vascular resistance measured by echocardiography(PVRe)in patients with high probability of pulmonary hypertension(PHe).Methods This prospective observational study enrolled adult PHe inpatients during routine echocardiographic assessment.Echocardiographic PVR was estimated by the ratio of peak tricuspid regurgitation velocity to the velocity-time integral of the right ventricular outflow tract.Clinical and echocardiographic data were collected.The endpoint was all-cause death or withdrawing treatment for deteriorating of multiple organs failure at follow-up.Results A total of 598patients were included,the median age was 76(IQR:69-83)years,52.7%of whom were male.A total of 35patients reached the endpoint at 92(42-156)days follow-up,who had higher values of PVRe[3.2(2.4-5.1)WU vs.2.8(2.2-3.6)WU,P=0.026].Multivariable Cox regression analysis revealed PVRe>5 WU to be independently associated with the endpoint,hazard ratio(HR)=6.59[95%confidence interval(CI)1.73-25.06,P=0.006],compared to the baseline of PVRe≤2WU.Conclusions PVRe>5WU is independently associated with adverse outcomes in patients with PHe,which can optimize risk stratification.

关 键 词：肺高血压 肺血管阻力 超声心动图 预后 

分 类 号：R540.45[医药卫生—心血管疾病] R544.1[医药卫生—内科学]