Zhao Y, Wang H, Chen M, Zhang N, Yang Z W, Li D, Wei W
Department of Rheumatology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Department of Cardiology, Tianjin Medical University General Hospital, Tianjin 300052, China.
Zhonghua Yi Xue Za Zhi. 2019 Oct 8;99(37):2921-2925. doi: 10.3760/cma.j.issn.0376-2491.2019.37.010.
To describe baseline characteristics of patients with primary Sjogren's syndrome (pSS) with right heart catheterization (RHC)-confirmed pulmonary arterial hypertension (PAH). This retrospective study included consecutive patients hospitalized with pSS-PAH from Jan.2013 to June.2019 in Tianjin Medical University General Hospital. All patients fulfilled the 2002 revised criteria for pSS proposed by the American-European Consensus Group. PAH was defined according to RHC-based European Society of Cardiology/European Respiratory Society guidelines. Associated variables were described and analyzed. Predictive factors for achieving treatment goals were explored. Sub-groups(based on Anti-SSB antibody positive/negative) were analyzed. Twenty patients with RHC-confirmed pSS-PAH were included (median age at onset, 54.5 years; median PAH duration, 12 months).PAH was the initial manifestation of pSS in 5 patients(26.3%), and shortness of breath was the most common symptom (17/20,85%). Mean pulmonary arterialpressure (mPAP) was 48(38, 55.75)mmHg, pulmonary vascularresistance (PVR) was 11.23 (6.17,14.69)IU, and mean cardiac index was 2.59(2.04,2.98)L·min(-1)·m(-2) in this group. In addition, right ventricular diameter≤40 mm[0.009, =5.92, 95(1.55, 22.59)] was predictive factor for achieving the treatment goal. Furthermore, compared with Anti-SSB antibody negative patients, patients with Anti-SSB antibody positive had a higher PVR(IU) [14.1(11.23, 22.63)vs 6.4(6.15, 12.36),0.025], a higher mPAP(mmHg)[5(48.5,59)vs 39(32.5,50.75),0.013], and a lower cardiac index (L·min(-1)·m(-2)) [2.1(1.6,2.5)vs 2.9(2.56,3.41),0.002]. pSS-PAH patients are mainly middle-aged women with the most common symptom shortness of breath. And PAH can be the first manifestation of pSS. More attention should be paid to patients with Anti-La/SSB antibody positive and right ventricular diameter ≤40 mm because of higher mPAP, PVR, worse cardiac function and prognosis.
描述经右心导管检查(RHC)确诊为肺动脉高压(PAH)的原发性干燥综合征(pSS)患者的基线特征。这项回顾性研究纳入了2013年1月至2019年6月在天津医科大学总医院因pSS-PAH住院的连续患者。所有患者均符合美国-欧洲共识小组2002年修订的pSS标准。PAH根据基于RHC的欧洲心脏病学会/欧洲呼吸学会指南进行定义。对相关变量进行描述和分析。探索实现治疗目标的预测因素。对亚组(基于抗SSB抗体阳性/阴性)进行分析。纳入了20例经RHC确诊的pSS-PAH患者(发病时中位年龄54.5岁;PAH中位病程12个月)。5例患者(26.3%)中PAH是pSS的初始表现,气短是最常见症状(17/20,85%)。该组平均肺动脉压(mPAP)为48(38,55.75)mmHg,肺血管阻力(PVR)为11.23(6.17,14.69)IU,平均心脏指数为2.59(2.04,2.98)L·min⁻¹·m⁻²。此外,右心室直径≤40 mm[0.009,χ² =5.92,95%CI(1.55,22.59)]是实现治疗目标的预测因素。此外,与抗SSB抗体阴性患者相比,抗SSB抗体阳性患者的PVR(IU)更高[14.1(11.23,22.63)对6.4(6.15,12.36),P = ~0.025],mPAP(mmHg)更高[5(48.5,59)对39(32.5,50.75),P = ~0.013],心脏指数(L·min⁻¹·m⁻²)更低[2.1(1.6,2.5)对2.9(2.56,3.41),P = ~0.002]。pSS-PAH患者主要为中年女性,最常见症状为气短。且PAH可为pSS的首发表现。对于抗La/SSB抗体阳性且右心室直径≤40 mm的患者应给予更多关注,因其mPAP、PVR更高,心功能及预后更差。 (注:原文部分统计数据后的括号内格式有些混乱,这里尽量按合理理解翻译并标注了可能的格式问题。)