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肺动脉高压特异性疗法在非世界卫生组织(WHO)I组肺动脉高压中的应用

Use of pulmonary arterial hypertension-specific therapy in non-WHO group I pulmonary hypertension.

作者信息

Shujaat Adil, Bellardini Jason, Cury James D, Bajwa Abubakr A

机构信息

From the Division of Pulmonary and Critical Care Medicine, University of Florida at Jacksonville.

出版信息

South Med J. 2015 Jan;108(1):51-7. doi: 10.14423/SMJ.0000000000000217.

Abstract

OBJECTIVES

The development of pulmonary hypertension (PH) in non-World Health Organization group I PH adversely affects exercise capacity. It is unclear whether pulmonary artery hypertension (PAH)-specific drugs improve pulmonary hemodynamics and exercise capacity in such patients.

METHODS

We performed a retrospective chart review of consecutive patients with non-World Health Organization group I PH treated with PAH-specific therapy.

RESULTS

We identified 24 patients. The mean (standard deviation) age was 48 (14.8) years. Seventeen (71%) patients were women. The 6-minute walk distance improved significantly for the whole group in an initial follow-up period of 4.6 (2.3) months; however, the improvement was seen only in patients with obstructive sleep apnea (OSA) or severe PH and it was not sustained during a longer follow-up period of 11.5 (4.1) months, except in patients with OSA. PH was treated with a variety of PAH-specific drugs, including combination therapy in five patients.

CONCLUSIONS

The use of PAH-specific therapy in selected patients with PH secondary to lung diseases, OSA, or sarcoidosis may result in significant improvement in 6-minute walk distance, particularly in patients with OSA or severe PH.

摘要

目的

在非世界卫生组织第一组肺动脉高压(PH)患者中,肺动脉高压的发展对运动能力有不利影响。尚不清楚肺动脉高压(PAH)特异性药物是否能改善此类患者的肺血流动力学和运动能力。

方法

我们对接受PAH特异性治疗的非世界卫生组织第一组PH连续患者进行了回顾性病历审查。

结果

我们确定了24例患者。平均(标准差)年龄为48(14.8)岁。17例(71%)为女性。在初始4.6(2.3)个月的随访期内,全组6分钟步行距离显著改善;然而,仅在阻塞性睡眠呼吸暂停(OSA)或重度PH患者中观察到这种改善,并且在11.5(4.1)个月的更长随访期内,除OSA患者外,这种改善并未持续。使用了多种PAH特异性药物治疗PH,包括5例患者采用联合治疗。

结论

在患有继发于肺部疾病、OSA或结节病的PH的特定患者中使用PAH特异性治疗可能会使6分钟步行距离显著改善,特别是在OSA或重度PH患者中。

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