肺高血压相关慢性肺病死亡率的预测因素
Jay Pescatore1, Matthew Bittner1, Gilbert D'Alonzo1
1Department of Thoracic Medicine and Surgery, Lewis Katz School of Medicine at Temple University Hospital, Philadelphia, PA 19140, USA.
Journal of clinical medicine
|June 27, 2024
概括
某些慢性肺部疾病,如异常性肺纤维化 (IPF) 和结合性肺纤维化和肺气 (CPFE),在患有肺高血压 (PH) 的患者中显著增加死亡风险. 肺功能低下和严重的PH也预示着更糟糕的结果.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 呼吸系统疾病 呼吸系统疾病
背景情况:
- 肺高血压 (PH) 是慢性肺病的常见并发症.
- PH与各种慢性肺部疾病的共存往往导致预后不佳.
- 在这种患者群体中确定死亡率预测因子对于临床管理至关重要.
研究的目的:
- 调查预测慢性肺病和PH患者死亡率的变量.
- 为了比较与PH相关的不同慢性肺病亚型的死亡风险.
主要方法:
- 793名患有慢性肺病和PH的患者的回顾性分析.
- 包括被诊断患有COPD,IPF,ILD (纤维化和非纤维化),纤维化沙尔科毒症和CPFE的患者.
- 使用了右心脏导管,肺功能测试和6分钟步行测试.
- 应用单变量和多变量考克斯回归来确定死亡率预测因素.
主要成果:
- 异形性肺纤维化 (IPF),其他纤维性ILD,非纤维性ILD和CPFE与增加的死亡率有关.
- 严重的PH (肺血管阻力>5WU),降低FEV1 (<30%),降低FVC (<40%),以及短6分钟步行距离 (<150米) 独立预测的死亡率.
- 患有IPF,CPFE,纤维性ILD或非纤维性ILD和PH的患者比患有COPD和PH的患者面临更高的死亡风险.
结论:
- 在PH的存在下诊断IPF,CPFE,纤维性ILD或非纤维性ILD与PH相比,COPD的死亡风险显著增加.
- 死亡率的关键独立预测因素包括严重的PH (PVR>5 WU),有限的6分钟步行距离 (<150米),以及严重的气流阻塞 (FEV1 <30%,FVC <40%).
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