在甲基胺相关的肺动脉高血压中,治疗反应和生存率
Cole Uhland1, Angela Gibbs2, Michael Insel1
1Division of Pulmonary, Allergy, Critical Care3 and Sleep Medicine University of Arizona Tucson AZ.
与甲基胺相关的肺动脉高血压 (Meth-PAH) 患者在积极治疗前环素时,表现出与异常性PAH (iPAH) 类似的结果. 持续使用甲基胺并没有使甲基PAH患者的疾病进展或生存情况恶化.
科学领域:
- 心脏病学 心脏病学
- 肺部病理学 肺部病理学
- 药理学 药理学是指药理学的学科.
背景情况:
- 甲基胺相关的肺动脉高血压 (Meth-PAH) 是一个新兴的临床问题.
- 与使用连续前环素的异常性PAH (iPAH) 相比,Meth-PAH的治疗结果和治疗反应尚未确定.
研究的目的:
- 为了比较Meth-PAH中的存活率,治疗反应和右心室功能,与接受亲腔前环素治疗的iPAH患者相比.
- 评估持续使用甲基胺对Meth-PAH的疾病进展和死亡率的影响.
主要方法:
- 对138名以前未接受过治疗的PAH患者 (64名Meth-PAH,74名iPAH) 进行了前性队列研究.
- 进行了标准化治疗,使用了内皮下prostinil.
- 进行了血液动力学评估,心脏成像和生存分析 (Kaplan-Meier,Cox回归).
主要成果:
- 甲基PAH和iPAH两组都出现了晚期疾病.
- 血液动力学有所改善,欧洲呼吸学会的风险得分在两组中都有所下降.
- 在平均46个月和67个月的随访期间,甲基PAH的无移植存活率为84.4%,IPAH为72.9%. 持续使用甲基胺并没有对结果产生负面影响.
结论:
- 在Meth-PAH和iPAH中,侵袭性肠道前环素治疗产生了可比的死亡率和治疗反应.
- 需要进一步研究甲基胺对PAH病原和患者结局的长期影响.
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