Gupta Ranju, Perumandla Sirisha, Patsiornik Yelena, Niranjan Selvanayagam, Ohri Anju
Department of Internal Medicine, Division of Hematology/ Oncology, Coney Island Hospital, 2601 Ocean Parkway, Brooklyn, NY 11235, USA.
J Natl Med Assoc. 2006 Nov;98(11):1779-82.
To assess the incidence of pulmonary hypertension (PH) in patients with chronic myeloproliferative disorders (CMPD).
Twenty-seven patients with a diagnosis of CMPD were included in the study. Patients were excluded if they had a secondary cause of PH. Diagnosis of PH was established if right ventricular systolic pressure (RVSP) by transthoracic echocardiography (TTE) was >35 mmHg.
Diagnosis of PH was established in 14 out of 27 patients. Two patients were excluded from analysis because of poor ejection fraction on TTE, resulting in a final diagnosis of PH in 12 of 25 (48%) patients. Of these 25 patients, seven of nine with essential thrombocytosis (ET), five of 14 with polycythemia vera (PV), and 0 out of two with chronic myeloid leukemia (CML) had PH. All patients were asymptomatic at the time of their most recent visit. There was no relationship between PH and age at diagnosis, duration of disease, platelet count and hematocrit at diagnosis or during follow-up, both for the entire cohort or for specific diagnosis of ET or PV.
Pulmonary hypertension appears to be common in patients with CMPD. Further studies are needed to evaluate the impact of treatment on PH and long-term survival in these patients.
评估慢性骨髓增殖性疾病(CMPD)患者中肺动脉高压(PH)的发生率。
27例诊断为CMPD的患者纳入本研究。若患者存在PH的继发原因则被排除。经胸超声心动图(TTE)测得右心室收缩压(RVSP)>35 mmHg,则诊断为PH。
27例患者中有14例确诊为PH。2例患者因TTE测得的射血分数低而被排除在分析之外,最终25例患者中有12例(48%)确诊为PH。在这25例患者中,9例原发性血小板增多症(ET)患者中有7例、14例真性红细胞增多症(PV)患者中有5例、2例慢性髓性白血病(CML)患者中0例患有PH。所有患者在最近一次就诊时均无症状。无论是整个队列还是ET或PV的特定诊断,PH与诊断时的年龄、疾病持续时间、诊断时或随访期间的血小板计数及血细胞比容均无关联。
肺动脉高压在CMPD患者中似乎很常见。需要进一步研究以评估治疗对这些患者的PH及长期生存的影响。