JAHA:阜外柳志红等发现预测肺动脉高压患者结局新指标

2017-07-05 朱柳媛 中国循环杂志

阜外医院柳志红教授等近期发表在《美国心脏协会杂志》上的一项研究提示,摄氧效率斜率(OUES)有助于预测特发性肺动脉高压患者病情恶化和死亡风险,而摄氧效率斜率指数(OUESI,即摄氧效率斜率与体表面积的比值)的预测价值更是优于每公斤体重峰值摄氧量(peak VO2/kg)和二氧化碳排出量(VE/VCO2)斜率。

阜外医院柳志红教授等近期发表在《美国心脏协会杂志》上的一项研究提示,摄氧效率斜率(OUES)有助于预测特发性肺动脉高压患者病情恶化和死亡风险,而摄氧效率斜率指数(OUESI,即摄氧效率斜率与体表面积的比值)的预测价值更是优于每公斤体重峰值摄氧量(peak VO2/kg)和二氧化碳排出量(VE/VCO2)斜率。

研究者发现,随着患者病情恶化,摄氧效率斜率值明显降低,且与峰值摄氧量关联度很好。OUESI ≤0.52 L/(min·m2)的患者的5年生存率明显降低,不到OUESI>0.52 L/(min·m2)者的一半。

该研究纳入210例特发性肺动脉高压患者,患者平均年龄32岁,最长随访66个月,中位随访41个月。随访期间,31例死亡,1例患者接受肺脏移植,85例患者病情恶化。

多因素分析表明,OUESI既是特发性肺动脉高压患者临床病情恶化的独立预测因素,也能独立预测死亡风险。另外,心脏指数也可独立预测临床病情恶化,N末端B型利钠肽原(NT-proBNP)水平则可预测死亡风险。

摄氧效率斜率是心肺运动试验中得出的一个参数,代表在递增负荷运动试验中,每分通气量(VE)每增加10倍,摄氧量(VO2)增加的速率。

原始出处:

Yi Tang, Qin Luo, et al. Oxygen Uptake Efficiency Slope Predicts Poor Outcome in Patients With Idiopathic Pulmonary Arterial Hypertension.  Journal of the American Heart Association. 2017;6:e005037 Originally published June 30, 2017 https://doi.org/10.1161/JAHA.116.005037

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    2017-07-07 zhaohui6731
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    2017-07-06 qq3586518b

    真真无语了!

    0

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    2017-07-05 131****1460

    学习了受益匪浅。

    0

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    2017-07-05 明月清辉

    谢谢分享,学习了

    0

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    2017-07-05 中医痴

    不错的,学习了,谢谢分享!

    0

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