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间歇性肺部疾病中的血液动力学模式:临床实践的快照和未来试验的路线图

Ho Cheol Kim¹, Christopher S King², Christopher A Thomas²

¹Department of Pulmonary and Critical Care Medicine, Asan Medical Center University of Ulsan College of Medicine Seoul South Korea.

Pulmonary circulation

|July 17, 2025

概括

带有肺高血压的间歇性肺病 (ILD-PH) 显示出不同的血液动力学. 现实世界的数据显示,毛囊前和严重PH的严重流行,强调需要在ILD患者早期右心脏导管.

科学领域:

肺部病理学肺部病理学
心脏病学心脏病学
关键护理医学关键护理医学

背景情况:

间歇性肺病 (ILD) 在由肺高血压 (PH) 复杂时显著增加死亡率.
有限的现实世界数据存在于接受右心导管治疗 (RHC) 的ILD患者的血液动力学概况.

研究的目的:

使用RHC数据来描述ILD患者的血液动力学概况.
根据世界肺高血压研讨会 (WSPH) 的不同标准来评估PH患病率和严重程度.
探索肺功能测试 (PFTs) 和肺血管抵抗 (PVR) 之间的相关性.

主要方法:

在2006年至2024年期间接受RHC的3541名ILD患者的回顾性分析.
基于第5,第6和第7个WSPH定义的血液动力学评估和严重的PH (PVR>5木单位).
分析了371名具有可用的RHC数据和肺动脉压 (PAWP) ≤15mmHg的患者.

主要成果:

在评估的ILD患者中,有12.2%接受了RHC.
在具有可用的RHC数据的患者中,49.6%,54.4%和69.4%分别满足了第5,第6和第7个WSPH毛囊前PH标准.
31.3%的患者表现出严重的PH (PVR>5木单位);在PFT变量 (DLco%,FVC%/DLco%) 和PVR之间发现了微弱的相关性.

结论:

在临床实践中,ILD-PH呈现出异构的血液动力学特征.
对ILD患者来说,需要提高警性和降低RHC的门值.
这些发现可以指导未来的临床试验,查和ILD-PH的管理策略.

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