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接受肺动脉高压特异性药物治疗的肺动脉高压患者的临床结局及治疗选择——单中心病例系列

Clinical Outcomes and Treatment Options in Patients With Pulmonary Hypertension Who Received Pulmonary Hypertension-Specific Drugs - Single-Center Case Series.

作者信息

Kamiya Chiaki, Odagiri Keiichi, Hakamata Akio, Inui Naoki, Watanabe Hiroshi

机构信息

Department of Clinical Pharmacology and Therapeutics, Hamamatsu University School of Medicine Hamamatsu Japan.

出版信息

Circ Rep. 2019 Aug 28;1(9):389-395. doi: 10.1253/circrep.CR-19-0059.

Abstract

Recent progress in the development of pulmonary hypertension (PH)-specific pharmaceutical agents has improved mortality and morbidity remarkably. Today, these PH-specific drugs have become a standard treatment for PH. We herein summarize the treatment options and longitudinal clinical outcomes of 21 patients with PH who received PH-specific drugs at the present institution. Sixteen patients began treatment with a single PH-specific drug; 9 of them needed additional PH-specific drugs, but the other 7 were still taking the same drug at the last follow-up. Five patients began treatment with a combination of 2 or 3 PH-specific drugs, and their drugs were not discontinued. Most patients (17/21) were taking a phosphodiesterase type 5 (PDE5) inhibitor at the last follow-up. During the 6.5±4.4 years' follow-up, 5 patients died, but only 1 death was related to PH. At 5 and 10 years, the estimated PH-related death-free and lung transplantation-free survival rate was 100% (95% CI: 100-100%) and 87.5% (95% CI: 38.7-98.1%), respectively. The estimated 5- and 10-year estimated overall survival rates were 77.9% (95% CI: 50.8-91.3%) and 68.2% (95% CI: 37.4-86.2%), respectively. PDE5 inhibitors played a central role in the treatment options. The long-term prognosis of PH was favorable at the present institution.

摘要

肺动脉高压(PH)特异性药物研发方面的最新进展显著改善了死亡率和发病率。如今,这些PH特异性药物已成为PH的标准治疗方法。我们在此总结了本机构中21例接受PH特异性药物治疗的PH患者的治疗选择和长期临床结果。16例患者开始使用单一PH特异性药物治疗;其中9例需要额外的PH特异性药物,但其他7例在最后一次随访时仍在服用同一种药物。5例患者开始使用2种或3种PH特异性药物联合治疗,且未停用药物。大多数患者(17/21)在最后一次随访时正在服用5型磷酸二酯酶(PDE5)抑制剂。在6.5±4.4年的随访期间,5例患者死亡,但只有1例死亡与PH相关。在5年和10年时,估计的无PH相关死亡和无肺移植生存率分别为100%(95%CI:100-100%)和87.5%(95%CI:38.7-98.1%)。估计的5年和10年总生存率分别为77.9%(95%CI:50.8-91.3%)和68.2%(95%CI:37.4-86.2%)。PDE5抑制剂在治疗选择中发挥了核心作用。在本机构中,PH的长期预后良好。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c7a/7892490/938d7f3f5422/circrep-1-389-g001.jpg

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