中国慢性血栓栓塞性肺动脉高压患者的特征和长期生存情况。
Characteristics and long-term survival of patients with chronic thromboembolic pulmonary hypertension in China.
机构信息
Department of Pulmonary Vascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Disease, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Respiratory and Critical Care Medicine, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
出版信息
Respirology. 2021 Feb;26(2):196-203. doi: 10.1111/resp.13947. Epub 2020 Sep 20.
BACKGROUND AND OBJECTIVE
The purpose of this study was to report the characteristics and long-term survival of patients with CTEPH treated in three distinct ways: PEA, BPA and medical therapy.
METHODS
Patients diagnosed with CTEPH were included in the registry that was set up in 18 centres from August 2009 to July 2018. The characteristics and survival of patients with CTEPH receiving the different treatments were reported. Prognostic factors were evaluated by Cox regression model.
RESULTS
A total of 593 patients with CTEPH were included. Eighty-one patients were treated with PEA, 61 with BPA and 451 with drugs. The estimated survival rates at 1, 3, 5 and 8 years were, respectively, 95.2%, 84.6%, 73.4% and 66.6% in all patients; 92.6%, 89.6%, 87.5% and 80.2% in surgical patients; and 95.4%, 88.3%, 71.0% and 64.1% in medically treated patients. The estimated survival rates at 1, 3, 5 and 7 years in patients treated with BPA were 96.7%, 88.1%, 70.0% and 70.0%, respectively. For all patients, PEA was an independent predictor of survival. Other independent risk factors were CHD, cardiac index, PVR, big endothelin-1, APE and 6MWD.
CONCLUSION
This is the first multicentre prospective registry reporting baseline characteristics and estimated survival of patients with CTEPH in China. The long-term survival rates are similar to those of patients in the international and Spanish registries. PEA is an independent predictor of survival.
背景与目的
本研究旨在报告三种不同治疗方法（肺动脉内膜剥脱术、球囊肺动脉成形术和药物治疗）治疗的 CTEPH 患者的特征和长期生存情况。
方法
2009 年 8 月至 2018 年 7 月，在 18 个中心设立登记处，纳入诊断为 CTEPH 的患者。报告不同治疗方法的 CTEPH 患者的特征和生存情况。通过 Cox 回归模型评估预后因素。
结果
共纳入 593 例 CTEPH 患者，81 例接受 PEA 治疗，61 例接受 BPA 治疗，451 例接受药物治疗。所有患者的估计 1、3、5 和 8 年生存率分别为 95.2%、84.6%、73.4%和 66.6%；手术患者分别为 92.6%、89.6%、87.5%和 80.2%；药物治疗患者分别为 95.4%、88.3%、71.0%和 64.1%。接受 BPA 治疗的患者的估计 1、3、5 和 7 年生存率分别为 96.7%、88.1%、70.0%和 70.0%。对于所有患者，PEA 是生存的独立预测因素。其他独立的危险因素包括 CHD、心指数、PVR、大内皮素-1、APE 和 6MWD。
结论
这是首个报告中国 CTEPH 患者基线特征和估计生存率的多中心前瞻性登记研究。长期生存率与国际和西班牙登记研究中的患者相似。PEA 是生存的独立预测因素。
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