Prevalence and risk factors for pulmonary artery systolic hypertension among sickle cell disease patients in Nigeria
Prevalence and risk factors for pulmonary artery systolic hypertension among sickle cell disease patients in Nigeria
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DOI：
10.1002/ajh.21162
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发表时间：
2008-06-01
影响因子：
12.8
通讯作者：
Gladwin, Mark T.
中科院分区：
文献类型：
--
作者：
Aliyu, Zakari Y.;Gordeuk, Victor;Gladwin, Mark T.
在美国成人镰状细胞病(SCD)患者中，肺动脉收缩期高血压很常见，且与死亡率增加有关。尽管SCD在撒哈拉以南非洲的患病率最高，但非洲尚未报告肺动脉收缩期高血压的频率和发展为肺动脉高压的危险因素。我们研究了208例稳定状态下未服用羟基脲的尼日利亚SCD患者和94名健康对照。将肺动脉收缩期高血压定义为三尖瓣返流速度=2.5m/s。结果与之前发表的美国SCD前瞻性队列进行了比较。与美国成年SCD患者46%的年龄相比，尼日利亚人中只有7%的人年龄在35岁。在尼日利亚的SCD患者中，25%的三尖瓣返流速度为2.5米/秒。较高的射速与较高的血清球蛋白(P=0.002)、血尿素氮(P=0.019)和乳酸脱氢酶浓度(P=0.026)以及不能在6min内步行300m(P=0.042)相关。与美国队列相比，尼日利亚患者有更多的溶血，表现为较低的血红蛋白和较高的乳酸脱氢酶浓度(P
Pulmonary artery systolic hypertension is common and associated with increased mortality among adult sickle cell disease (SCD) patients in the United States. Although the prevalence of SCD is highest in sub-Saharan Africa, the frequency of pulmonary artery systolic hypertension and the risk factors for the development of pulmonary hypertension have not been reported from Africa. We studied 208 hydroxyurea naive Nigerian SCD patients at steady state and 94 healthy controls. Pulmonary artery systolic hypertension was defined prospectively as tricuspid regurgitant jet velocity >= 2.5 m/sec. Results were compared with a previously published US prospective SCD cohort. Only 7% of Nigerians compared with 46% of US adults with SCD were >35 years. Tricuspid regurgitant jet velocity was >= 2.5 m/sec in 25% of Nigerian SCD patients. Higher jet velocity was associated with greater serum globulin (P = 0.002), blood urea nitrogen (P = 0.019) and lactate dehydrogenase concentrations (P = 0.026) and with inability to walk >300 m in 6 min (P = 0.042). Compared with the US cohort, Nigerian patients had more hemolysis as indicated by lower hemoglobin and higher lactate dehydrogenase concentrations (P