Arthritis Rheumatol:系统性硬化症并发肺动脉高压和间质性肺病的患病率、治疗和预后

2019-02-20 xiangting MedSci原创

在这个大型SSc-ILD队列中,相当大比例的患者并发PH,PH通常发生在诊断后的早期。

系统性硬化症(SSc)与间质性肺病(ILD)和肺动脉高压(PH)相关。这项研究旨在确定SSc相关性ILD队列(SSc-ILD)中PH患者的患病率、特征、治疗和预后。

这是一项前瞻观察性队列研究,纳入高分辨率计算机断层扫描(HRCT)上的SSc-ILD患者。基于标准化筛查算法对受试者进行PH筛查,如果有指征,则进行右心导管检查(RHC)。基于血流动力学和HRCT上的ILD程度对PH进行分类。计算使用Kaplan Meier法的汇总统计和存活率。

纳入了93名SSc-ILD受试者;76%为女性,65.6%为弥漫性SSc,平均年龄为54.9岁,平均SSc病程为8年。29名受试者(31.2%)经RHC证实为PH;这29名受试者中,24.1%患有PAH,55.2%患有WHO III组PH,34.5%患有WHO III组PH并伴肺血管阻力> 3.0 Wood单位,48.3%在SSc发病7年内被诊断患有PH,82.8%接受ILD治疗,82.8%接受PAH治疗。所有受试者在SSc-ILD诊断后3年的存活率为97%。SSc-ILD伴PH患者PH诊断后3年的存活率为91%。

在这个大型SSc-ILD队列中,相当大比例的患者并发PH,PH通常发生在诊断后的早期;大多数患者接受了ILD和PAH治疗,且存活率良好。应当对SSc-ILD患者进行并发PH的评估。

原始出处:

Amber Young. Prevalence, Treatment and Outcomes of Coexistent Pulmonary Hypertension and Interstitial Lung Disease in Systemic Sclerosis. Arthritis Rheumatol. 14 February 2019.

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    2019-03-05 amy0559
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createdName=amy0559, createdTime=Tue Mar 05 01:16:00 CST 2019, time=2019-03-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1972605, encodeId=f03e19e260542, content=<a href='/topic/show?id=8a6a2e8839' target=_blank style='color:#2F92EE;'>#Arthritis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2788, encryptionId=8a6a2e8839, topicName=Arthritis)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIibticIBly5jCSic5ZElW4He3rO4DMpUHUFaFX57OicNMnzckWaicBNeStwugWHFCuOdicoakApM4HGmtw/132, createdBy=f8672500006, createdName=ms6390871039024434, createdTime=Tue Jun 18 05:16:00 CST 2019, time=2019-06-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1925270, encodeId=b5f719252e016, content=<a href='/topic/show?id=26d633354c9' target=_blank style='color:#2F92EE;'>#动脉高压#</a>, beContent=null, 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href='/topic/show?id=a7a7e359478' target=_blank style='color:#2F92EE;'>#硬化症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73594, encryptionId=a7a7e359478, topicName=硬化症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Sep 27 18:16:00 CST 2019, time=2019-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1815793, encodeId=39a31815e9365, content=<a href='/topic/show?id=82e99e291b0' target=_blank style='color:#2F92EE;'>#间质性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97291, encryptionId=82e99e291b0, topicName=间质性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99cf2500102, createdName=zjshifan_98647306, createdTime=Sun Dec 29 01:16:00 CST 2019, time=2019-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250606, encodeId=e2f61250606b1, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357105, encodeId=33d1135e10527, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627351, encodeId=058d162e3516b, content=<a href='/topic/show?id=dbcee69217e' target=_blank style='color:#2F92EE;'>#系统性硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76921, encryptionId=dbcee69217e, topicName=系统性硬化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8cf521117287, createdName=yhy100207, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=)]
  5. [GetPortalCommentsPageByObjectIdResponse(id=2017123, encodeId=4b77201e12307, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Fri Dec 06 02:16:00 CST 2019, time=2019-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671916, encodeId=1f3616e1916f2, content=<a href='/topic/show?id=58378220131' target=_blank style='color:#2F92EE;'>#肺病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82201, encryptionId=58378220131, topicName=肺病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2f0826868454, 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href='/topic/show?id=a7a7e359478' target=_blank style='color:#2F92EE;'>#硬化症#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=28, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=73594, encryptionId=a7a7e359478, topicName=硬化症)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a691420, createdName=30397604, createdTime=Fri Sep 27 18:16:00 CST 2019, time=2019-09-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1815793, encodeId=39a31815e9365, content=<a href='/topic/show?id=82e99e291b0' target=_blank style='color:#2F92EE;'>#间质性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97291, encryptionId=82e99e291b0, topicName=间质性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=99cf2500102, createdName=zjshifan_98647306, createdTime=Sun Dec 29 01:16:00 CST 2019, time=2019-12-29, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1250606, encodeId=e2f61250606b1, content=<a href='/topic/show?id=7d6f52988e1' target=_blank style='color:#2F92EE;'>#患病率#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=52988, encryptionId=7d6f52988e1, topicName=患病率)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f49517, createdName=xinmeili, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357105, encodeId=33d1135e10527, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=27, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1627351, encodeId=058d162e3516b, content=<a href='/topic/show?id=dbcee69217e' target=_blank style='color:#2F92EE;'>#系统性硬化#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76921, encryptionId=dbcee69217e, topicName=系统性硬化)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=8cf521117287, createdName=yhy100207, createdTime=Fri Feb 22 06:16:00 CST 2019, time=2019-02-22, status=1, ipAttribution=)]
    2019-11-28 丁鹏鹏
  6. [GetPortalCommentsPageByObjectIdResponse(id=2017123, encodeId=4b77201e12307, content=<a href='/topic/show?id=9760e69058c' target=_blank style='color:#2F92EE;'>#系统性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76905, encryptionId=9760e69058c, topicName=系统性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2b9b368, createdName=qingrejiedu, createdTime=Fri Dec 06 02:16:00 CST 2019, time=2019-12-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1671916, encodeId=1f3616e1916f2, content=<a href='/topic/show?id=58378220131' target=_blank style='color:#2F92EE;'>#肺病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=82201, encryptionId=58378220131, topicName=肺病)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=2f0826868454, 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  7. 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    2019-02-22 zhaojie88
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研究结果显示SP-D是SSc-ILD的相关诊断生物标志物,而KL-6可以评估肺纤维化严重程度。

Ann Rheum Dis:系统性硬化症患者脂肪来源基质血管组分的分子谱和促血管生成活性

这项研究首次证明了SSc不会损害SVF的血管修复能力,支持其用作创新性自体生物疗法。

Arthritis Rheumatol:系统性硬化症患者右心室输出储备减少,肺动脉压轻度升高

这项研究结果表明,mPAP轻度升高的SSc患者6MWD受损可能是由运动期间的PAC减少和RV输出储备减少引起的。