地中海贫血中肺动脉高压的临床指标。

Clinical indicators for pulmonary arterial hypertension in thalassemia.

作者信息

Chueamuangphan Nonlawan, Wongtheptien Wattana, Nawarawong Weerasak, Sukornthasarn Apichard, Chuncharunee Suporn, Tawichasri Chamaiporn, Patumanond Jayanton

机构信息

Department of Medicine, Chiang Rai Hospital, Chiang Rai, Thailand.

出版信息

J Med Assoc Thai. 2012 Jan;95(1):16-21.

PMID:22379736

Abstract

OBJECTIVE

To explore clinical indicators for pulmonary arterial hypertension (PAH) in thalassemia (Thal).

MATERIAL AND METHOD

A study was conducted in thalassemia patients at Chiang Rai Hospital, Chiang Rai, Thailand. Pulmonary artery systolic pressure (PASP) was determined by doppler echocardiography and PAH was defined as PASP > 35 mmHg. Patient characteristics were extracted from medical records. Characteristics of patients with and without PAH were compared. Risk indicators were explored with logistic regression analysis.

RESULTS

Two hundred twenty four patients were included, 144 E/beta-Thal, 37 homozygous beta-Thal and 43 Hb H disease. There were 65 patients (29.0%) with PAH, 53 (81.5%) with E/beta-Thal, 8 (12.3%) with homozygous beta-Thal and 4 (6.2%) with Hb H disease. In a multivariable analysis, features significantly associated with PAH were E/beta-Thal (OR = 1.98, 95% CI; 1.29-3.01) and post splenectomy status (OR = 2.36, 95% CI; 1.17-4.73).

CONCLUSION

Significant indicators for PAH in thalassemia were E/beta-Thal and post splenectomy status.

摘要

目的

探讨地中海贫血（Thal）患者肺动脉高压（PAH）的临床指标。

材料与方法

在泰国清莱清莱医院对地中海贫血患者进行了一项研究。通过多普勒超声心动图测定肺动脉收缩压（PASP），PAH定义为PASP>35 mmHg。从病历中提取患者特征。比较有和没有PAH的患者的特征。通过逻辑回归分析探索风险指标。

结果

纳入224例患者，其中144例为E/β地中海贫血，37例为纯合子β地中海贫血，43例为血红蛋白H病。有65例患者（29.0%）患有PAH，其中53例（81.5%）为E/β地中海贫血，8例（12.3%）为纯合子β地中海贫血，4例（6.2%）为血红蛋白H病。在多变量分析中，与PAH显著相关的特征是E/β地中海贫血（OR = 1.98，95%CI；1.29 - 3.01）和脾切除术后状态（OR = 2.36，95%CI；1.17 - 4.73）。