在间歇性肺部疾病中查肺高血压:PHINDER研究的初步结果
David Zisman1, Sandeep Sahay2, Debabrata Bandyopadhyay3
1Division of Pulmonary Medicine, Cleveland Clinic Florida, 3100 Weston Rd., Weston, FL, 33331, USA. zismand@ccf.org.
Advances in therapy
|March 10, 2026
概括
肺高血压 (PH) 复杂化了间歇性肺病 (ILD),但查缺乏. 在PHINDER研究中,从肺功能测试,成像和心声学中确定了关键参数,以改善ILD患者的早期PH检测.
科学领域:
- 肺部医学 肺部医学
- 心脏病学 心脏病学
- 放射学 放射学是一门学科.
背景情况:
- 间歇性肺病 (ILD) 经常导致肺高血压 (PH),显著影响患者的结果.
- 目前在ILD中检测PH的查没有标准化,导致诊断延迟和治疗不足.
- 为了弥补这一缺口,PHINDER研究 (NCT05776225) 被启动,通过确定ILD中PH的检测参数来弥补这一缺口.
研究的目的:
- 确定可靠的参数,以便在患有间歇性肺病 (ILD) 的患者中早期检测毛囊前肺高血压 (PH).
- 制定一个结构化的PH在ILD的查策略,提高诊断准确性和及时性.
主要方法:
- 来自ILD患者的前性,多中心数据收集,包括临床,生理和成像评估.
- 毛囊前PH的定义:平均肺动脉压>20 mmHg,肺动脉压≤15 mmHg,肺血管阻力 (PVR) >2木单位 (WU).
- 在通过右心导管注射 (RHC) 确认之前,使用非侵入性评估估计PH概率.
主要成果:
- 对190名参与者的初步分析显示,55%的人患有毛囊前PH,14%的人患有严重PH (PVR>5 WU).
- 与毛囊前PH相关的重要参数包括补充氧的使用,DLCO,FVC%/DLCO%比率,RVSP/TAPSE比率,TR速度,PA扩大,PA/大动脉直径比率和RV/LV直径比率.
- 与血液动力学确认相比,临床姿态评估显示PH检测的准确性有限 (60%).
结论:
- 肺功能检测,肺成像和回声心脏成像的复合使用显示出改善ILD早期毛细管前PH检测的前景.
- PHINDER研究的最终数据将指导开发一种经过验证,基于证据的ILDPH查工具.
- 确定连续变量的值将有助于在ILD中诊断PH,促进及时和准确的查策略.
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