Chen Yonghua, Liu Chunli, Lu Wenju, Li Mengxi, Hadadi Cyrus, Wang Elizabeth Wenqian, Yang Kai, Lai Ning, Huang Junyi, Li Shiyue, Zhong Nanshan, Zhang Nuofu, Wang Jian
1 State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Disease, The Affiliated Hospital of Guangzhou Medical University, Guangdong 510120, China ; 2 Geisinger Medical Center, 100 North Academy Avenue, Danville, USA ; 3 Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, USA.
J Thorac Dis. 2016 Mar;8(3):350-8. doi: 10.21037/jtd.2016.02.58.
Chronic respiratory disease-associated pulmonary hypertension (PH) is an important subtype of PH, which lacks clinical epidemiological data in China.
Six hundred and ninety three patients hospitalized from 2010 to 2013 were classified by echocardiography according to pulmonary arterial systolic pressure (PASP): mild (36≤ PASP <50 mmHg); moderate (50≤ PASP <70 mmHg) and severe (PASP ≥70 mmHg).
Dyspnea (93.51%) was the most common symptom. Hemoptysis observed in the severe group (6.42%) was significantly higher than the other two groups (P<0.05). COPD (78.35%), lung bullae (44.16%), tuberculosis (including obsolete pulmonary tuberculosis) (38.82%), and bronchiectasis (30.45%) were frequently present. Mild group occupied the highest proportion (84.7%) in COPD, while severe group occupied the highest proportion (19.3%) in pulmonary embolism (P<0.01). Age, partial pressure of oxygen (PaO2), hematocrit (HCT), partial pressure of carbon dioxide (PaCO2), increase of N-terminal pro brain natriuretic peptide (NT-proBNP) and right ventricular (RV) diameter (>20 mm) were associated with moderate-to-severe PH, while RV [odds ratio (OR) =3.53, 95% CI, 2.17-5.74], NT-proBNP (OR=2.44, 95% CI, 1.51-3.95), HCT (OR=1.03, 95% CI, 1.00-1.07) and PaCO2 (OR=1.01, 95% CI, 1.00-1.03) were independent risk factors.
PH related to respiratory diseases is mostly mild to moderate, and the severity is associated with the category of respiratory disease. Increased HCT can be an independent risk factor for PH related to chronic respiratory diseases.
慢性呼吸道疾病相关肺动脉高压（PH）是PH的一种重要亚型，中国缺乏其临床流行病学数据。
对2010年至2013年住院的693例患者，根据肺动脉收缩压（PASP）通过超声心动图进行分类：轻度（36≤PASP<50mmHg）；中度（50≤PASP<70mmHg）和重度（PASP≥70mmHg）。
呼吸困难（93.51%）是最常见症状。重度组咯血发生率（6.42%）显著高于其他两组（P<0.05）。慢性阻塞性肺疾病（COPD）（78.35%）、肺大疱（44.16%）、肺结核（包括陈旧性肺结核）（38.82%）和支气管扩张（30.45%）较为常见。轻度组在COPD中占比最高（84.7%），而重度组在肺栓塞中占比最高（19.3%）（P<0.01）。年龄、氧分压（PaO2）、血细胞比容（HCT）、二氧化碳分压（PaCO2）、N末端脑钠肽前体（NT-proBNP）升高及右心室（RV）直径（>20mm）与中重度PH相关，而RV[比值比（OR）=3.53，95%可信区间（CI），2.17 - 5.74]、NT-proBNP（OR = 2.44，95%CI，1.51 - 3.95）、HCT（OR = 1.03，95%CI，1.00 - 1.07）和PaCO2（OR = 1.01，95%CI，1.00 - 1.03）是独立危险因素。
与呼吸道疾病相关的PH大多为轻度至中度，其严重程度与呼吸道疾病类型有关。HCT升高可能是慢性呼吸道疾病相关PH的独立危险因素。
