Lei Si, Tang Doudou, Xu Nianru, Wu Shangjie
Department of Respiratory Medicine, Second Xiangya Hospital, Central South University, Hunan Evidence-based Medicine Center, Changsha 410011, China.
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2017 Jun 28;42(6):641-646. doi: 10.11817/j.issn.1672-7347.2017.06.007.
To investigate the demographic characteristics and the causes for pulmonary hypertension (PH) in adult patients. Methods: A total of 2 508 adult patients diagnosed as PH, who came from the Second Xiangya Hospital of Central South University from January 2010 to December 2014, were retrospectively investigated. All subjects underwent the clinical diagnosis, or the echocardiographic diagnosis, or thetraditional hemodynamic criteria by right heart catheterization (RHC). The patient's data including hospital numbers, gender, ages, primary diseases, etc, are collected and analyzed. Results: In this study, the number of patients diagnosed as PH was increased year by year. The median age of 2 508 patients was 47 (18-93) years old, and there were 933 males (37.2%), the ratio of male to female was 1:1.69 (P<0.05). Female was more common in Class I PH (pulmonary arterial hypertension) and Class II PH (pulmonary hypertension due to left heart disease)(>70%), but there were more male patients (74.5%) in Class III PH (pulmonary hypertension due to lung diseases and/or hypoxia). In our study, 896 cases (35.73%) were the Class I PH, 1 163 cases was the Class II PH (46.37%), 411 cases was the Class III PH (16.39%), and the Class IV PH (chronic thromboembolic pulmonary hypertension) and the Class V PH (PH with unclear and/or multifactorial mechanisms) were diagnosed in 32(1.27%) and 6 patients (0.24%), respectively.The diseases with largest number of patients for the top 7 primary PH were rheumatic heart disease (1 090, 43.48%), congenital heart disease (692, 27.60%), chronic obstructive pulmonary disease (358, 14.28%), connective tissue related disease(156, 6.22%), valvular heart disease (66, 2.63%), idiopathic PH (46, 1.83%) and pulmonary embolism (27, 1.08%). Conclusion: Adult PH patients' peak incidence age is 41-50 years old. This disease is more common among women, and the Class I/II PH are common in women while the Class III is more common in men. Rheumatic heart disease and congenital heart disease may be the most common cause for pulmonary hypertension in China, and chronic obstructive pulmonary disease is the most common cause for the Class III PH, in which the patients are old.
探讨成年肺动脉高压(PH)患者的人口统计学特征及病因。
回顾性研究2010年1月至2014年12月在中南大学湘雅二医院确诊为PH的2508例成年患者。所有受试者均接受临床诊断、超声心动图诊断或右心导管检查(RHC)的传统血流动力学标准诊断。收集并分析患者的医院编号、性别、年龄、原发疾病等数据。
本研究中,确诊为PH的患者数量逐年增加。2508例患者的中位年龄为47(18 - 93)岁,男性933例(37.2%),男女比例为1:1.69(P<0.05)。女性在I类PH(肺动脉高压)和II类PH(左心疾病所致肺动脉高压)中更为常见(>70%),但在III类PH(肺部疾病和/或缺氧所致肺动脉高压)中男性患者更多(74.5%)。本研究中,896例(35.73%)为I类PH,1163例为II类PH(46.37%),411例为III类PH(16.39%),IV类PH(慢性血栓栓塞性肺动脉高压)和V类PH(机制不明和/或多因素所致肺动脉高压)分别诊断出32例(1.27%)和6例(0.24%)。前7种主要PH患者数量最多的疾病依次为风湿性心脏病(1090例,43.48%)、先天性心脏病(692例,27.60%)、慢性阻塞性肺疾病(358例,14.28%)、结缔组织相关疾病(156例,6.22%)、瓣膜性心脏病(66例,2.63%)、特发性PH(46例,1.83%)和肺栓塞(27例,1.08%)。
成年PH患者的发病高峰年龄为41 - 50岁。该病在女性中更为常见,I/II类PH在女性中常见,而III类在男性中更常见。风湿性心脏病和先天性心脏病可能是中国肺动脉高压最常见的病因,慢性阻塞性肺疾病是III类PH最常见的病因,此类患者年龄较大。