Incidence and Clinical Characteristics of Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis
Incidence and Clinical Characteristics of Pulmonary Hypertension in Patients with Idiopathic Pulmonary Fibrosis
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DOI：
10.4103/0366-6999.154284
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发表时间：
2015-04-05
影响因子：
6.1
通讯作者：
Dai, Hua-Ping
中科院分区：
文献类型：
--
作者：
Yan, Wei;Peng, Li-Ying;Dai, Hua-Ping
背景资料：肺动脉高压（PH）经常使特发性肺纤维化（IPF）患者的病程复杂化，并与显著更差的结局相关。目的：探讨肺动脉高压（PH）在IPF患者中的发生率及其与肺动脉收缩压（sPAP）的相关性。方法：收集2004年1月至2011年12月间经多普勒超声心动图检查sPAP的住院IPF患者，采用回顾性分析方法，对患者的临床资料进行分析。根据2009年欧洲心脏病学会/欧洲呼吸学会PH指南，通过估计sPAP > 50 mmHg将患者定义为PH，并将其分级为可能PH、可能PH和不太可能PH。结果：共纳入119例IPF患者，其中可能PH 28例（23.5%），可能PH 20例（16.8%），不太可能PH 71例（59.7%）。博格呼吸困难评分与sPAP呈正相关，r = 0.467，P < 0.001。血氧饱和度与sPAP呈负相关，r =-0.416，P < 0.001。肺一氧化碳弥散量预测值与sPAP呈负相关，r =-0.424，P = 0.003。脑钠肽前体N末端片段和肺动脉宽度与sPAP呈正相关，r分别为0.452，P = 0.011和0.513，P < 0.001。PH可加重IPF患者的呼吸困难、右心功能障碍，降低患者的生活质量。
Background: Pulmonary hypertension (PH) frequently complicates the course of idiopathic pulmonary fibrosis (IPF) patients and is associated with significantly worse outcomes. The aim of the present study was to investigate the incidence of PH in IPF patients and evaluate the correlation between clinical parameters and systolic pulmonary artery pressure (sPAP).Methods: Hospitalized patients with IPF, who were evaluated for sPAP by Doppler echocardiography from January 2004 to December 2011, were enrolled in our study. Patients were defined as PH by an estimated sPAP > 50 mmHg and graded as PH likely, PH possible and PH unlikely, based on the 2009 European Society of Cardiology/European Respiratory Society PH Guidelines. The correlations between clinical parameters and sPAP were analyzed by multiple linear regression.Results: Totally, 119 IPF patients were enrolled in our study and 28 (23.5%), 20 (16.8%) and 71 (59.7%) patients were PH likely, PH possible and PH unlikely, respectively. Borg dyspnea score was positively correlated with sPAP, r = 0.467, P < 0.001. Oxygen saturation was negatively correlated with sPAP, r = -0.416, P < 0.001. Diffusing capacity of the lung for carbon monoxide percentage predicted was negatively correlated with sPAP, r = -0.424, P = 0.003. N-terminal fragment of pro-brain natriuretic peptide and pulmonary artery width was positively correlated with sPAP, r = 0.452, P = 0.011 and r = 0.513, P < 0.001, respectively.Conclusions: The incidence of PH in IPF patients was 23.5% in a single center of China. PH may worsen the dyspnea, right heart dysfunction and decrease the life quality of the patients with IPF.