Chung Wook-Jin, Park Yong Bum, Jeon Chan Hong, Jung Jo Won, Ko Kwang-Phil, Choi Sung Jae, Seo Hye Sun, Lee Jae Seung, Jung Hae Ok
Department of Cardiovascular Medicine, Gachon Cardiovascular Research Institute, Gachon University Gil Medical Center, Incheon, Korea.
Division of Pulmonology, Department of Internal Medicine, Hallym University Gangdong Sacred Heart Hospital, Seoul, Korea.
J Korean Med Sci. 2015 Oct;30(10):1429-38. doi: 10.3346/jkms.2015.30.10.1429. Epub 2015 Sep 12.
Despite recent advances in understanding of the pathobiology and targeted treatments of pulmonary arterial hypertension (PAH), epidemiologic data from large populations have been limited to western countries. The aim of the Korean Registry of Pulmonary Arterial Hypertension (KORPAH) was to examine the epidemiology and prognosis of Korean patients with PAH. KORPAH was designed as a nationwide, multicenter, prospective data collection using an internet webserver from September 2008 to December 2011. A total of 625 patients were enrolled. The patients' mean age was 47.6 ± 15.7 yr, and 503 (80.5%) were women. The diagnostic methods included right heart catheterization (n = 249, 39.8%) and Doppler echocardiography (n = 376, 60.2%). The etiologies, in order of frequency, were connective tissue disease (CTD), congenital heart disease, and idiopathic PAH (IPAH) (49.8%, 25.4%, and 23.2%, respectively). Patients with WHO functional class III or IV at diagnosis were 43.4%. In total, 380 (60.8%) patients received a single PAH-specific treatment at the time of enrollment, but only 72 (18.9%) patients received combination therapy. Incident cases during the registry represented 297 patients; therefore, the incidence rate of PAH was 1.9 patients/yr/million people. The 1st-, 2nd-, and 3rd-yr estimated survival rates were 90.8%, 87.8%, and 84.4%, respectively. Although Korean PAH patients exhibited similar age, gender, and survival rate compared with western registries, they showed relatively more CTD-PAH in the etiology and also systemic lupus erythematosus among CTD-PAH. The data suggest that earlier diagnosis and more specialized therapies should be needed to improve the survival of PAH patients.
尽管近年来在肺动脉高压(PAH)的病理生物学理解和靶向治疗方面取得了进展,但来自大量人群的流行病学数据仅限于西方国家。韩国肺动脉高压注册研究(KORPAH)的目的是研究韩国PAH患者的流行病学和预后情况。KORPAH设计为一项全国性、多中心的前瞻性数据收集研究,于2008年9月至2011年12月期间通过互联网网络服务器进行。共纳入625例患者。患者的平均年龄为47.6±15.7岁,其中503例(80.5%)为女性。诊断方法包括右心导管检查(n = 249,39.8%)和多普勒超声心动图(n = 376,60.2%)。病因按频率依次为结缔组织病(CTD)、先天性心脏病和特发性PAH(IPAH)(分别为49.8%、25.4%和23.2%)。诊断时WHO功能分级为III或IV级的患者占43.4%。总共有380例(60.8%)患者在入组时接受了单一PAH特异性治疗,但只有72例(18.9%)患者接受了联合治疗。注册研究期间的新发病例有297例;因此,PAH的发病率为每年每百万人1.9例。第1年、第2年和第3年的估计生存率分别为90.8%、87.8%和84.4%。尽管韩国PAH患者与西方注册研究中的患者在年龄、性别和生存率方面相似,但在病因方面CTD-PAH相对更多,且在CTD-PAH中系统性红斑狼疮更为常见。数据表明,需要更早的诊断和更专业的治疗来提高PAH患者的生存率。