JAHA:轻度肺动脉高压与死亡率升高相关:系统评价和meta分析

2018-09-19 xiangting MedSci原创

轻度PH患者的死亡风险升高,轻度PH定义为测量的或计算的平均肺动脉压>19mmHg。

最近有研究表明,与平均肺动脉压相关的临床风险连续性始于>19mmHg,这低于用于定义肺动脉高压(PH)的传统阈值25 mmHg。由于其对患者诊断和预后的影响,这些数据的普遍性和有效性需要进一步的验证。

检索数据库2018年1月31日之前发表的、比较平均肺动脉压轻度升高但<25 mmHg患者与对照组全因死亡率的研究。meta分析包括15项非随机研究和16482名患者(7451名患者[45.2%] 测量或通过右心导管[n=6037]和超声心动图[n=1414]计算平均肺动脉压19-24mmHg [轻度PH])。平均随访时间为5.2年。与对照组相比,轻度PH与死亡风险升高相关(风险比,1.52;95%置信区间,1.32-1.74;P<0.001;I2=47%)。使用风险调整时间-事件估算的二次分析的结果类似(风险比,1.19;95%置信区间,1.09-1.31;P<0.001;I2=42%)。右心导管和超声心动图亚组之间的结果一致(P相互作用>0.05)。有证据表明存在发表偏倚;然而,这并未影响风险评估(Duval和Tweedie调整和填充调整风险比,1.34;95%置信区间,1.15-1.56)。

轻度PH患者的死亡风险升高,轻度PH定义为测量的或计算的平均肺动脉压>19mmHg。这些数据强调了需要将诊断为轻度PH的患者纳入调查药物和非药物治疗措施的PH 临床研究,以减少临床风险并改善预后。

原始出处:
Dhaval Kolte  Suvasini Lakshmanan  Matthew D,et al. Mild Pulmonary Hypertension Is Associated With Increased Mortality: A Systematic Review and Meta‐Analysis. JAHA. 18 September 2018.

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    2018-12-19 guojianrong
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    2019-04-27 一闲
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    2018-09-21 zhaohui6731
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    2018-09-21 huagfeg
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    2018-09-19 明天jing

    肺动脉高压表面是罕见病,事实上临床上并不少见,治疗药物虽然有一些,但是整体仍然不理解,可能未来需要采用综合治疗措施。

    0

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    2018-09-19 清风拂面

    谢谢分享学习

    0

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