靶向药物治疗肺动脉高压患者的近期随访  

Recent follow-up of targeted agents in patients with pulmonary hypertension

作　　者：孙楠楠 黄玮[3] 王诚 SUN Nannan;HUANG Wei;WANG Cheng(Department of Cardiology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China;Chongqing public health medical center,Chongqing 400000,China;Department of Cardiology,First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China)

机构地区：[1]徐州医科大学附属医院心内科,江苏徐州221000 [2]重庆市公共卫生医疗救治中心,重庆400000 [3]重庆医科大学附属第一医院心内科,重庆400000

出　　处：《临床肺科杂志》2025年第1期57-65,共9页Journal of Clinical Pulmonary Medicine

摘　　要：目的 探讨肺动脉高压诊疗中心就诊的肺动脉高压患者临床特点并观察靶向药物治疗的疗效,分析肺动脉高压患者发生心血管不良事件的危险因素。方法 回顾性研究收集了2016年1月至2021年2月于徐州医科大学附属医院和重庆医科大学附属第一医院首次住院的肺动脉高压患者124例,分析患者的临床特点、主要病因、首发症状等;观察靶向药物治疗后总体疗效;总结心血管不良事件的发生情况,分析危险因素。结果 以女性患者为主[103例(83.1%)],发病中位年龄38.0(27.5, 51.0)岁。呼吸困难是最常见的首发症状(85.0%)。先天性心脏病相关肺动脉高压占比最高(49.2%)。>38岁组心功能较差且具有高的脑钠肽水平(P<0.05)。以5型磷酸二酯酶抑制剂+内皮素受体拮抗剂的两联治疗方案最为常见(88.0%),高危患者占比明显下降。结论 肺动脉高压患者以女性多见,年龄越大心功能越差,以先天性心脏病相关的肺动脉高压多见,靶向药物治疗效果显著,1年生存率显著提高。心指数是肺动脉高压患者的保护因素。Objective To explore the clinical characteristics of patients with pulmonary hypertension treated in pulmonary hypertension treatment center,observe the efficacy of targeted drug therapy,and analyze the risk factors of cardiovascular adverse events in patients with pulmonary hypertension.Methods A retrospective study was conducted to collect 124 patients with pulmonary hypertension who were hospitalized for the first time in the Affiliated Hospital of Xuzhou Medical University and the First Affiliated Hospital of Chongqing Medical University from January 2016 to February 2021.The clinical characteristics,main etiology and first symptoms of the patients were analyzed.The overall effect of targeted drug therapy was observed.Summarize the occurrence of cardiovascular adverse events and analyze the risk factors.Results Mainly female patients,103 cases(83.1%),and the median age of onset was 38.0(27.5,51.0)years.Dyspnea was the most common first-episode symptom(85.0%).Pulmonary arterial hypertension related to congenital heart disease accounted for the highest proportion(49.2%).The 38-year-old group had poor cardiac function and high level of brain natriuretic peptide(P<0.05).With type 5 phosphodiesterase inhibitor+endothelin receptor antagonist was the most common(88%),and the proportion of high-risk patients was significantly decreased.Conclusion Pulmonary hypertension is more common in women,and the heart function deteriorates with age.Pulmonary hypertension related to congenital heart disease is more common,and the targeted drug therapy has a remarkable effect,and the 1-year survival rate is significantly improved.Cardiac index is a protective factor in patients with pulmonary hypertension.

关 键 词：肺动脉高压 危险因素 靶向药物 随访 

分 类 号：R544.1[医药卫生—心血管疾病]