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多发性肌炎中的肺动脉高压

Pulmonary hypertension in polymyositis.

作者信息

Wang Han, Liu Tao, Cai Ying-ying, Luo Lian, Wang Meng, Yang Mengmeng, Cai Lin

机构信息

Cardiovascular Disease Research Institute, The Third People's Hospital of Chengdu, 82 Qinlong St, Chengdu, Sichuan, 610031, People's Republic of China.

Department of Neurology, People's Hospital of Hainan Province, 19 Xiuhua Road, Haikou, Hainan, 570311, People's Republic of China.

出版信息

Clin Rheumatol. 2015 Dec;34(12):2105-12. doi: 10.1007/s10067-015-3095-7. Epub 2015 Oct 14.

Abstract

Pulmonary hypertension (PH) is relatively common in connective tissue diseases. However, few studies have focused on the pulmonary hypertension (PH) associated with polymyositis (PM). Our aim is to investigate the prevalence of PH and determine the associated factors for PH in patients with PM. Multicenter study of 61 patients with PM underwent evaluation including general information, physical examination, laboratory indictors, thoracic high-resolution CT (HRCT) imaging, and transthoracic echocardiography (TTE). TTE was performed to estimate the pulmonary arterial pressure. PH was defined as resting systolic pulmonary artery pressure (sPAP) ≥40 mmHg. PH was identified in ten patients (16.39 %) who had few cardiopulmonary symptoms. PM patients with PH had higher prevalence of interstitial lung disease (ILD) and pericardial effusion (PE) compared with patients without PH (18 vs. 11.5 %, p = 0.005; 11.5 vs. 9.8 %, p = 0.004; respectively). After controlling for age, gender, and potential factors, ILD and PE were independently associated with PH in patients with PM in multivariate analysis (OR = 8.193, 95 % CI 1.241-54.084, p = 0.029; OR = 8.265, 95 % CI 1.298-52.084, p = 0.025; respectively). Depending on TTE, the possible prevalence of PH was 16.39 % in patients with PM. Both ILD and PE may contribute to the development of PH in PM.

摘要

肺动脉高压(PH)在结缔组织病中相对常见。然而,很少有研究关注与多发性肌炎(PM)相关的肺动脉高压(PH)。我们的目的是调查PM患者中PH的患病率,并确定PH的相关因素。对61例PM患者进行多中心研究,评估内容包括一般信息、体格检查、实验室指标、胸部高分辨率CT(HRCT)成像和经胸超声心动图(TTE)。通过TTE来估计肺动脉压。PH定义为静息收缩期肺动脉压(sPAP)≥40 mmHg。在10例几乎没有心肺症状的患者中发现了PH(16.39%)。与无PH的患者相比,有PH的PM患者间质性肺疾病(ILD)和心包积液(PE)的患病率更高(分别为18%对11.5%,p = 0.005;11.5%对9.8%,p = 0.004)。在控制年龄、性别和潜在因素后,多因素分析显示ILD和PE在PM患者中与PH独立相关(OR分别为8.193,95%CI 1.241 - 54.084,p = 0.029;OR为8.265,95%CI 1.298 - 52.084,p = 0.025)。根据TTE,PM患者中PH的可能患病率为16.39%。ILD和PE都可能促使PM患者发生PH。

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