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2012年至2019年肺动脉高压的分类、诊断及治疗现状:云南省单中心研究

[Classification, diagnosis and treatment status of pulmonary hypertension from 2012 to 2019: a single center study in Yunnan province].

作者信息

Feng X L, Lu Y B, Yang D, Xue Q, Zhang J L, Lin C R, Gan P, Zhang W H, Guang X F, Dai H L

机构信息

Department of Cardiology, Yan'an Affiliated Hospital, Kunming Medical University, Clinical Medicine Center and Key Laboratory for Cardiovascular Disease of Yunnan Province, Kunming 650051, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2023 Nov 24;51(11):1188-1193. doi: 10.3760/cma.j.cn112148-20230919-00173.

Abstract

To analyze the classification, diagnosis and treatment status of patients with pulmonary hypertension (PH) in Yunnan province. This was a retrospective study. Hospitalized patients with PH at Yan'an Affiliated Hospital of Kunming Medical University from January 2012 to December 2019 were enrolled. The clinical data of enrolled patients, including demographic data, comorbidities, targeted drug therapy, echocardiography and right heart catheterization results, were obtained through the electronic medical record system. The composition ratio of PH, diagnosis and treatment were analyzed. A total of 13 590 patients with PH were enrolled, accounting for 3.09% (13 590/440 056) of the total number of hospitalizations during the same period. The composition of PH was predominantly pulmonary arterial hypertension (PAH) (55.50% (7 542/13 590)), followed by pulmonary hypertension (PH) caused by left heart disease (24.16% (3 284/13 590)). Among them, PAH could be subdivided into four types: idiopathic pulmonary arterial hypertension (IPAH), PAH associated with connective tissue disease, PAH associated with portal hypertension, and PAH associated with congenital heart disease (CHD-PAH), with CHD-PAH as the predominating type (98.09% (7 398/7 542). Patients with PAH were predominantly adolescents. In hospitalized patients with PH, from 2012 to 2019, the proportion of children and adolescents showed a decreasing trend from year to year, and the proportion of middle-aged and older adults showed a significant increasing trend, and the proportion of female patients showed a gradual decreasing trend, and the proportion of patients with comorbid hypertension, diabetes mellitus, coronary artery disease, arrhythmia, and pneumonia showed an increasing trend. A total of 1 034 patients (7.61% (1 034/13 590)) underwent right heart catheterization. The concordance rate between echocardiographic and right heart catheterization findings was (86.98% (875/1 006)). A total of 2 574 (18.94%) of PH patients were treated with PAH targeted drugs, of which 58.16% (1 497/2 574) were treated with monotherapy. Among the PH patients treated with PAH targeted drugs, the majority of patients were PAH patients (86.44% (2 225/2 574)), and 83.53% (2 150/2 574) patients treated with PAH targeted drugs were CHD-PAH. Hospitalized PH patients in our center between 2012 and 2019 are predominantly CHD-PAH, and the proportion of patients receiving right heart catheterization and targeted drug therapy is relatively low. The percentage of middle-aged and elderly PH patients shows an increasing trend from year to year, as well as the percentage of those with concomitant comorbidities.

摘要

分析云南省肺动脉高压(PH)患者的分类、诊断及治疗状况。本研究为回顾性研究。纳入2012年1月至2019年12月在昆明医科大学附属延安医院住院的PH患者。通过电子病历系统获取纳入患者的临床资料,包括人口统计学数据、合并症、靶向药物治疗、超声心动图及右心导管检查结果。分析PH的构成比、诊断及治疗情况。共纳入13590例PH患者,占同期住院总人数的3.09%(13590/440056)。PH的构成以肺动脉高压(PAH)为主(55.50%(7542/13590)),其次是左心疾病所致肺动脉高压(24.16%(3284/13590))。其中,PAH可细分为四种类型:特发性肺动脉高压(IPAH)、结缔组织病相关PAH、门脉高压相关PAH以及先天性心脏病相关PAH(CHD-PAH),以CHD-PAH为主(98.09%(7398/7542))。PAH患者以青少年为主。在2012年至2019年住院的PH患者中,儿童和青少年的比例逐年呈下降趋势,中年及老年患者比例呈显著上升趋势,女性患者比例呈逐渐下降趋势,合并高血压、糖尿病、冠心病、心律失常及肺炎的患者比例呈上升趋势。共有1034例患者(7.61%(1034/13590))接受了右心导管检查。超声心动图与右心导管检查结果的符合率为86.98%(875/1006)。共有2574例(18.94%)PH患者接受了PAH靶向药物治疗,其中58.16%(1497/2574)接受单药治疗。在接受PAH靶向药物治疗的PH患者中,大多数为PAH患者(86.44%(2225/2574)),接受PAH靶向药物治疗的患者中83.53%(2150/2574)为CHD-PAH。2012年至2019年我院中心住院的PH患者以CHD-PAH为主,接受右心导管检查及靶向药物治疗的患者比例相对较低。中年及老年PH患者的比例逐年呈上升趋势,合并症患者的比例也是如此。

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