Lancet respir med:肺动脉高压患者肺血管阻力与心血管不良预后风险

2020-07-28 MedSci原创 MedSci原创

研究认为,肺动脉高压患者肺血管阻力升高2.2个Wood单位及以上时,患者的死亡和心力衰竭的临床风险显著增加,这一阈值相比之前的3.0个Wood单位有较大幅度降低

一般认为对于肺动脉高压患者,肺血管阻力(PVR)升高3.0Wood单位及以上导致预后不良风险增加,近日研究人员就肺动脉高压患者PVR与不良临床结局之间的关系进行了考察。
 
研究人员对美国退伍军人事务医疗保健系统(2007年10月1日至2016年9月30日)中接受右心导管插入术(RHC)患者进行了回顾性队列研究。研究的主要结果为全因死亡率,通过Cox比例风险模型用于评估PVR与预后之间的关系。
 
研究包含40082名患者,其中男性38751名,中位年龄66.5岁,中位随访1153天,部分患者有心力衰竭史的患者和慢性阻塞性肺疾病。 研究的重点是肺动脉高压的风险患者,其基础是平均肺动脉压(mPAP)至少为19mmHg。连续变量分析发下,患者PVR升高2.2个wood单位与全因死亡危险增加相关,相比于PVR升高程度低于2.2个Wood人群,PVR升高2.2个wood单位以上患者校正后的死亡率危险比(HR)为1.71,心力衰竭住院的调整危险比(HR)为1.27。验证队列中包括2870名mPAP至少为19mmHg的患者,经调整后, mPAP大于 19mm Hg,PVR增加2.2wood单位,肺动脉楔形压为15mm或以下患者的死亡风险为1.81。
 
研究认为,肺动脉高压患者肺血管阻力升高2.2个Wood单位及以上时,患者的死亡和心力衰竭的临床风险显著增加,这一阈值相比之前的3.0个Wood单位有较大幅度降低。
 
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    2021-07-07 howi
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    2020-07-28 goodbing

    顶刊就是不一样,质量很高,内容精彩!学到很多

    0

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    2020-07-28 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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