摘要
目的了解特发性肺动脉高压（IPAH）患者的人口学和临床特征。方法自2007年5月至2010年10月，在全国31个临床中心纳入经右心导管确诊的成人IPAH患者，收集所有患者的一般情况、临床特征以及血液动力学指标，并且将所有患者分为WHO肺动脉高压功能Ⅰ／Ⅱ和Ⅲ／Ⅳ级两组，比较两组患者的血液动力学特征。结果本研究共纳入150例患者。所有患者平均年龄（36±13）岁，男性50例，女性100例，男女比为1：2。体质指数为（21．3±3．5）kg／m2。乏力（123例，82．0％）和呼吸困难（112例，74。7％）是最常见的症状，肺动脉瓣第2心音亢进是最常见体征（138例，92．0％）。约有49．0％（73例）的患者WHO肺动脉高压功能分级为Ⅲ级，功能分级Ⅱ级的患者占46．0％（68例）。6min步行距离和Borg呼吸困难评分分别为（337±101）m和2．0（2．0，4．0）。93．1％（140例）患者心电图表现右心室肥厚。右心导管测右心房压为（10±6）filmHg（1mmHg=0．133kPa），肺动脉平均压（61±16）mmHg，心指数（2．3±0．8）L·min-1·m-2和肺血管阻力（1484±699）dyn·s-1·cm-5。结论IPAH多累及青壮年，以女性为主，体质指数偏低。多数患者就诊时WHO肺动脉高压功能分级较差，血液动力学状况不佳。患者血液动力学的损害与6min步行距离及心功能分级相关。
Objective To explore the demographic characteristics and clinical features of patients with idiopathic pulmonary arterial hypertension （IPAH） in China. Methods Between March 2007 and September 2010, IPAH diagnosis was confirmed by right heart catheterization in 150 adult patients from 31 clinical centers in China. Clinical and hemodynamie data were analyzed and patients were divided into WHO functional class Ⅰ/Ⅱ and WHO functional class Ⅲ/Ⅳ group. Results The mean age of 150 patients were 36 ± 13 years with female patient/male patient ratio of 2 ： 1, and mean BMI was （ 21.3 ± 3.5 ） kg/m2. Fatigue （n = 123,82. 0% ） and dyspnea （n = 112,74. 7% ） are the most common symptoms. Accentuated pulmonie second sound （ P2 ） was detected in 92. 0% （ n = 138 ） of patients during physical examination, which was also the most common sign. About 49.0% （ n = 73 ） patients were WHO functional class Ⅰ/ Ⅱ patients and 46. 0% （ n = 68 ） patients were WHO functional class Ⅲ/Ⅳ patients. Six minutes walking distance （6MWD） and Borg dyspnea score was （337 ± 101 ） m and 2.0 （2. 0,4. 0） , respectively. Right ventricnlar hypertrophy was suggested by ECG in 93.1% （n = 140 ）patients . Right atrial pressure was （10 ±6） mm Hg, mean pulmonary artery pressure was （61 ± 16） mm Hg, cardiac index was （2. 3 ±0. 8） L min-1 · m-2 and puhnonary vascular resistance（ 1484 ±699） dyn· s-1·cm-5 in this cohort. 6 MWD （305 m ±89 m vs. 377 m ±88 m） was significantly shorter while Borg dyspnea score [3.0 （3.0,5.0） vs. 2. 0 （2.0,3, 0） I was significantly higher in WHO functional class Ⅱ/Ⅳ patients than in WHO functional class Ⅰ/Ⅱ patients. Similarly hemodynamie parameters were also worse in WHO functional class Ⅲ/Ⅳ patients than in WHO functional class Ⅰ/ Ⅱ patients （ all P 〈 0. 05 ）. Conclusion Idiopathic pulmonary arterial hypertension patients in this cohort affect mostly young adults, dominated by female gender and lower body mass index. Fatigue and dyspnea are the most common symptoms and accentuated pulmonic second sound （ P2 ） is the most common sign. IPAH patients are often displaying severe functional and hemodynamie disturbance at first visit to hospitals. Dyspnea and hemodynamic impairment are related to 6MWD and WHO functional class.
出处
《中华心血管病杂志》
CAS
CSCD
北大核心
2012年第8期657-661,共5页
Chinese Journal of Cardiology
基金
国家“十一五”科技支撑计划资助项目（2006BA101A07）
关键词
高血压
肺性
心室功能障碍
血液动力学
Hypertension, pulmonary
Ventrieular dysfunction
Hemodynamie features
