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肺动脉高压患者的扩张主肺动脉直径在肺移植后会减小。

Diameter of the dilated main pulmonary artery in patients with pulmonary hypertension decreases after lung transplantation.

机构信息

Department of Thoracic Surgery, Kyoto University, 54 Shogoin-Kawahara-cho, Sakyo-ku, Kyoto, 606-8507, Japan.

Department of Thoracic Surgery, Kobe City Medical Center General Hospital, 2 Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan.

出版信息

Surg Today. 2020 Mar;50(3):275-283. doi: 10.1007/s00595-019-01887-6. Epub 2019 Oct 8.

Abstract

PURPOSE

The pulmonary artery (PA) in patients with pulmonary hypertension (PH) becomes dilated. We analyzed the postoperative changes of the main PA after lung transplantation (LuTx).

METHODS

The subjects of this retrospective study were 68 LuTx recipients, divided into a PH group (n = 36) and a non-PH group (n = 32), based on preoperative right heart catheterization findings. The PA diameter was measured on chest computed tomography. We evaluated the correlation between the mean pulmonary arterial pressure (mPAP) and the main PA diameter and compared the main PA diameters before and 3 months after LuTx.

RESULTS

The main PA diameter was significantly correlated with the mPAP (r = 0.423, P < 0.001). Preoperatively, the mean main PA diameter in the PH group was significantly greater than that in the non-PH group. However, by 3 months after LuTx, the main PA diameter in the PH group had decreased significantly from 32.4 ± 6.7 to 26.9 ± 4.8 mm (P < 0.001), while that in the non-PH group had decreased minimally from 28.3 ± 4.9 to 26.4 ± 4.6 mm (P < 0.001), resulting in no significant difference in postoperative main PA diameters between the two groups.

CONCLUSIONS

The main PA diameter in recipients with PH was enlarged and correlated with the mPAP. The dilated main PA diameter in PH patients decreased shortly after LuTx.

摘要

目的

肺动脉(PA)在肺动脉高压(PH)患者中会扩张。我们分析了肺移植(LuTx)后主肺动脉的术后变化。

方法

本回顾性研究的对象为 68 例 LuTx 受者,根据术前右心导管检查结果分为 PH 组(n=36)和非 PH 组(n=32)。通过胸部计算机断层扫描测量 PA 直径。我们评估了平均肺动脉压(mPAP)与主肺动脉直径之间的相关性,并比较了 LuTx 前后 3 个月主肺动脉直径的变化。

结果

主肺动脉直径与 mPAP 呈显著相关性(r=0.423,P<0.001)。PH 组术前主肺动脉平均直径明显大于非 PH 组。然而,LuTx 后 3 个月,PH 组主肺动脉直径从 32.4±6.7 显著减小至 26.9±4.8mm(P<0.001),而非 PH 组从 28.3±4.9 减小至 26.4±4.6mm(P<0.001),两组术后主肺动脉直径无显著差异。

结论

PH 受者的主肺动脉直径增大并与 mPAP 相关。PH 患者扩张的主肺动脉直径在 LuTx 后很快缩小。

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