患有进行性块状纤维化的尘肺病患者的肺动脉高压

Pulmonary hypertension in patients with pneumoconiosis with progressive massive fibrosis.

作者信息

Yu Shiwen, Wang Yiran, Fan Yali, Ma Ruimin, Wang Yuanying, Ye Qiao

机构信息

Department of Occupational Medicine and Toxicology, Clinical Center for Interstitial Lung Diseases, Beijing Institute of Respiratory Medicine, Beijing Chao-Yang Hospital Capital Medical University, Beijing, China.

出版信息

Occup Environ Med. 2022 Jun 2. doi: 10.1136/oemed-2021-108095.

DOI:10.1136/oemed-2021-108095

PMID:35654579

Abstract

OBJECTIVES

This study aims to explore the prevalence and clinical features of pulmonary hypertension (PH) in patients with progressive massive fibrosis (PMF) and its correlation with large opacities on CT scans.

METHODS

This retrospective study collected 235 patients with PMF, and 199 were eligible for analysis. The probability of PH development was estimated based on tricuspid regurgitation velocity measured by echocardiogram. The size and the location of large opacities on chest CT were recorded. Potential risk factors for PH secondary to PMF were analysed using regression analysis.

RESULTS

The prevalence of a high or intermediate probability of PH was 39.7% in patients with PMF. Type C of large opacities (OR 6.99, 95% CI 2.34 to 23.00, p<0.001) and central type of the large opacities (OR 8.12, 95% CI 2.89 to 24.71, p<0.001) were identified as the risk factors for PH secondary to PMF. Over a median follow-up of 32.8 months, the survival rate was 73.3% in the PH group, significantly lower than that in the non-PH group (96.6%, p<0.001).

CONCLUSIONS

Over one-third of patients with PMF developed PH. The increased size and the central distribution of large opacities were identified as the risk factors.

摘要

目的

本研究旨在探讨进行性大块纤维化（PMF）患者肺动脉高压（PH）的患病率、临床特征及其与CT扫描上大阴影的相关性。

方法

这项回顾性研究收集了235例PMF患者，其中199例符合分析条件。根据超声心动图测量的三尖瓣反流速度估计PH发生的概率。记录胸部CT上大阴影的大小和位置。采用回归分析方法分析PMF继发PH的潜在危险因素。

结果

PMF患者中PH高概率或中概率的患病率为39.7%。大阴影C型（比值比6.99，95%可信区间2.34至23.00，p<0.001）和大阴影中央型（比值比8.12，95%可信区间2.89至24.71，p<0.001）被确定为PMF继发PH的危险因素。在中位随访32.8个月期间，PH组的生存率为73.3%，显著低于非PH组（96.6%，p<0.001）。