Chen Qiu-hong, Lu Lin, Qi Guo-rong, Jin Xin-hui, Wang Li-ming, Qi Sheng-gui
Qinghai Special Hospital for Cardiocerebrovascular Diseases, Xining, China.
Zhonghua Yi Xue Za Zhi. 2011 Nov 29;91(44):3120-2.
To explore the incidence of congenital heart disease (CHD) complicated with pulmonary arterial hypertension (PAH) at an altitude of over 2000 meters above sea level.
We retrospectively analyzed the profiles of 688 PAH patients selected from 1178 CHD patients at our hospital during January 2007 to December 2009. The risk factors of CHD-PAH were analyzed by age, altitude, etiologies and nationalities.
Among 1178 CHD patients, 688 (58.4%) suffered PAH. And 239 PAH cases (54.8%) were found in 436 male patients and 449 PAH cases (60.5%) in 742 female patients (χ(2) = 3.667, P = 0.058). The difference was not significant. The incidences of PAH in CHD patients varied at different altitudes (χ(2) = 10.507, P = 0.005). And 55.2%, 57.2% and 68.7% were found in < 2500 m, 2500 - 3500 m and > 3500 m groups respectively. And the > 3500 m group was statistically higher than those of the < 2500 m and 2500 - 3500 m groups (χ(2) = 9.924, P = 0.005) (χ(2) = 8.007, P = 0.005). The mean pulmonary arterial systolic pressure (PASP) of < 2500 m group was (58 ± 18) mm Hg, 2500 - 3500 m was (63 ± 17) mm Hg and > 3500 m was (64 ± 19) mm Hg. There were significant differences among them. In age composition of CHD-PAH, the highest ratio appeared before the age of 18 years old for PDA (patent ductus arteriosus)-PAH and VSD (ventricular septal defect)-PAH while that of ASD-PAH at the ages of 30 - 39 years old. There were not statistical differences among all nationalities (χ(2) = 5.404, P = 0.248).
The incidence of CHD-PAH at a high altitude is significantly higher than those at a low altitude. Hypoxia may promote the occurrence and development of PAH in CHD patients.
探讨海拔2000米以上地区先天性心脏病（CHD）合并肺动脉高压（PAH）的发病率。
回顾性分析我院2007年1月至2009年12月期间从1178例CHD患者中选取的688例PAH患者的资料。通过年龄、海拔、病因和民族分析CHD-PAH的危险因素。
1178例CHD患者中，688例（58.4%）患有PAH。436例男性患者中有239例PAH病例（54.8%），742例女性患者中有449例PAH病例（60.5%）（χ² = 3.667，P = 0.058）。差异无统计学意义。CHD患者中PAH的发病率在不同海拔地区有所不同（χ² = 10.507，P = 0.005）。海拔<2500米、2500 - 3500米和>3500米组的发病率分别为55.2%、57.2%和68.7%。>3500米组在统计学上高于<2500米和2500 - 3500米组（χ² = 9.924，P = 0.005）（χ² = 8.007，P = 0.005）。<2500米组的平均肺动脉收缩压（PASP）为（58±18）mmHg，2500 - 3500米组为（63±17）mmHg，>3500米组为（64±19）mmHg。它们之间存在显著差异。在CHD-PAH的年龄构成中，动脉导管未闭（PDA）-PAH和室间隔缺损（VSD）-PAH在18岁之前的比例最高，而房间隔缺损（ASD）-PAH在30 - 39岁时比例最高。各民族之间无统计学差异（χ² = 5.404，P = 0.248）。
高海拔地区CHD-PAH的发病率显著高于低海拔地区。缺氧可能促进CHD患者PAH的发生和发展。
