一个临床决策工具,用于系统性硬化症相关的肺高血压的风险分层患者
Justin K Lui1, Kari R Gillmeyer2, Ruchika A Sangani2
1The Pulmonary Center, Boston University Chobanian & Avedisian School of Medicine, 72 East Concord Street, R‑304, Boston, MA, 02118, USA. justin.lui@bmc.org.
Lung
|November 13, 2023
概括
一个新的评分系统有助于识别患有系统性硬化症 (SSc) 的肺高血压 (PH) 风险患者. 这种工具还可以预测死亡率,有助于早期检测和管理SSc患者的PH.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 类风湿病学 类风湿病学
背景情况:
- 系统性硬化症 (SSc) 与高风险的肺高血压 (PH) 有关.
- 在SSc中早期发现PH对于及时干预和改善结果至关重要.
- 目前的诊断方法可能是侵入性的,可能会推迟治疗.
研究的目的:
- 开发和验证一个评分系统,用于识别有PH风险的SSc患者.
- 评估该系统预测PH的SSc患者全因死亡率的能力.
- 创建一个简化的临床决策工具,以更早地检测SSc.中的PH.
主要方法:
- 使用肺功能测试,心声回声和胸部CT成像的7个变量开发了一个评分系统.
- 该得分应用于117名SSc患者的回顾性队列.
- 对PH的诊断性能 (灵敏度,特异性,准确性) 用右心导管检查作为黄金标准来评估.
主要成果:
- 在SSc患者中,60人 (51.3%) 诊断出肺高血压 (PH).
- 评分系统 (值≥0) 显示PH检测的灵敏度为0.87,特异性为0.74,准确度为0.80.
- 每一点的得分增加都与所有原因死亡率的调整后危险比率增加1.19倍有关.
结论:
- 开发的评分系统是一个有前途的工具,用于识别患PH风险的SSc患者.
- 该得分还预测了全因死亡率,提供了预后价值.
- 需要在外部队列中进行进一步的验证,以建立这种简化临床决策工具,用于SSc早期PH检测的例行使用.
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