低DLCO可以提供有关PAH患者治疗反应的见解,无论其减少的原因是什么
Effrosyni Dima1, Stylianos E Orfanos2, Vasileios Grigoropoulos1
1Pulmonary Hypertension Center of "Evangelismos" Hospital and 1st Department of Critical Care Medicine and Pulmonary Services, Medical School, National and Kapodistrian University of Athens, "Evangelismos" Hospital, 10676 Athens, Greece.
肺动脉高血压 (PAH) 中一氧化碳 (DLCO) 扩散能力低的患者是老年人,男性和吸烟者. 这一PAH亚组的预后不佳,对血管扩张疗法的反应有限.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 呼吸系统生理学 呼吸系统生理学
背景情况:
- 肺动脉高血压 (PAH) 涉及不同的病因和影响气体交换的组织学变化.
- 在PAH中减少一氧化碳 (DLCO) 扩散能力可以表明病理生物学和预后,但不能确切确定原因.
- 根据DLCO识别不同的PAH亚群,可以完善理解和治疗.
研究的目的:
- 调查低DLCO的PAH患者是否代表一个独特的亚群.
- 描述低DLCO的PAH患者的临床特征和治疗反应.
主要方法:
- 对69名PAH患者进行了回顾性研究.
- 分为两个组:DLCO ≥45% (第一组) 和DLCO <45% (第二组).
- 群体之间的人口,临床,血液动力学和治疗数据的比较.
主要成果:
- 与第一组相比,第二组 (低DLCO) 患者年龄较大,男性更频繁,有吸烟史.
- 第二组表现出较高的肺血管阻力 (PVR),但与平均肺动脉压 (PAP) 相似.
- 第二组的患者在治疗后没有改善WHO功能类,6分钟步行距离或NT-proBNP.
结论:
- 低DLCO的PAH患者具有不同的临床特征,包括年龄较大,男性性别和吸烟史.
- 在PAH中低DLCO与预后不佳和对血管扩张疗法的反应减少有关.
- 对于PAH患者的表型和指导治疗策略,尤其是新出现的治疗目标,DLCO非常有价值.
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