肺高血压在慢性阻塞性肺病中的患病率和预后值
Evgeni V Mekov1, Nikolay A Yanev1, Nedelina Kurtelova1
1Department of Pulmonary Diseases, Medical University - Sofia, Sofia, BGR.
Cureus
|March 12, 2025
概括
肺高血压 (PH) 在COPD患者中很常见,平均肺动脉压 (PAPm) 升高预示着更多的恶化. 非侵入性PAPm评估可以改善COPD风险分层和患者的治疗结果.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 诊断成像 诊断成像 诊断成像
背景情况:
- 肺高血压 (PH) 恶化慢性阻塞性肺病 (COPD) 的预后,增加恶化和死亡率.
- 通过超声波评估的平均肺动脉压 (PAPm) 可以帮助评估COPD的严重程度.
研究的目的:
- 评估COPD患者在休息和运动后平均肺动脉压 (PAPm) 的一年预后值.
主要方法:
- 对96名稳定的COPD患者 (年龄大于40岁,吸烟者,FEV1/FVC<0.7) 的前性观察研究.
- 胸外回声心脏成像测量了休息时的PAPm和6分钟后的步行测试 (6MWT).
- 对患者进行了12个月的随访,以检查恶化和死亡率.
主要成果:
- PH的流行率为52.1%.
- 休息时的PAPm是一个比运动后的PAPm (AUC 0.700) 更强的恶化预测因子 (AUC 0.732).
- PH患者经历了更多的恶化 (1.65对0.89,p=0.002);PAPm≥30运动后也与更高的恶化 (1.64对1.1,p=0.026) 相关.
结论:
- 在这个COPD队列中,PH的发病率很高.
- 休息和运动后PAPm升高与恶化的频率增加相关.
- 整合非侵入性PAPm测量可以提高COPD风险分层和指导治疗.
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