慢性血栓栓塞性肺高血压的并发症负担:影响和结果
Burcak Kilickiran Avci1, Ibrahim Basarici2, Mehmet Akbulut3
1Department of Cardiology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul 34098, Turkey.
Medicina (Kaunas, Lithuania)
|May 28, 2025
概括
慢性血栓栓塞性肺高血压 (CTEPH) 中常见的并发症影响患者的健康和治疗选择. 管理这些情况至关重要,特别是对于那些接受肺内关节切除术 (PEA) 的人来说.
科学领域:
- 心脏病学 心脏病学
- 肺部医学 肺部医学
- 临床结果研究研究
背景情况:
- 伴随性疾病 (共存的疾病) 复杂化了慢性疾病的管理和结果.
- 慢性血栓栓塞性肺高血压 (CTEPH) 管理受到伴随性疾病的影响,但它们的具体影响未得到充分研究.
- 了解并发症负担对于优化CTEPH患者护理至关重要.
研究的目的:
- 确定CTEPH患者共发病的流行率和负担.
- 分析并发症与临床表现,治疗决策和生存之间的关联.
- 根据肺内关节切除术 (PEA) 状态来分层发现.
主要方法:
- 来自8个中心的187名CTEPH患者 (2009-2020) 的回顾性分析.
- 确定和分类心血管和非心血管并发症 (0,1-2,或≥3).
- 对6分钟步行距离 (6MWD),血液动力学,可操作性和存活率的并发症影响的评估.
主要成果:
- 90%的CTEPH患者患有并发症;49%患有≥3.
- 诸如高血压和CKD等并发症与较低的6MWD和更差的血液动力学相关.
- 伴随性疾病使39%的可手术患者无法接受PEA; ≥3个心血管伴随性疾病使PEA后的生存率恶化.
- PEA手术和基线6MWD独立预测死亡率.
结论:
- 高并发症负担在CTEPH中普遍存在,影响功能状态,血液动力学和手术资格.
- 伴随性疾病对PEA后的长期生存有负面影响,但在未经手术的患者中预后较差.
- 对于CTEPH患者来说,仔细的可操作性评估和积极的并发症管理至关重要.
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