Dong Ruimin, Shui Xing, Zhang Juan, Dun Zhu
Department of Cardiology, the Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Department of Internal Medicine, Chaya County People's Hospital, Changdu, China.
Cardiovasc Diagn Ther. 2024 Aug 31;14(4):462-477. doi: 10.21037/cdt-23-486. Epub 2024 Aug 15.
Pulmonary hypertension (PH) is a critical health issue marked by high blood pressure in the pulmonary arteries, with limited data on its clinical characteristics in the Tibetan population. The objective of this study was to examine the clinical characteristics of PH patients among Tibetan population residing in Chaya County, Changdu, Tibet.
This was a retrospective cross-sectional study. A total of 94 PH patients diagnosed via echocardiography at the Internal Medicine Department of Chaya County People's Hospital in Changdu (Tibet, China) between March 2019 and October 2020 were included. Additionally, 52 non-PH inpatients were selected as the control group. Patient medical records were reviewed for demographic and clinical data, lab results, and echocardiographic findings. Student's -test/chi-squared test between PH and control group, one-way analysis of variance (ANOVA) among control and PH subgroups, Pearson's and Spearman's correlation coefficient were used to analysis the results.
Out of 1,689 inpatients in the Internal Medicine Department, 94 were identified as PH patients for analysis. The average hemoglobin level among PH patients (150.64±21.67 g/L) was similar to that observed in the normal population (146.65±17.51 g/L) at high altitude (P=0.28). Abnormal liver function indexes were observed, with 51.06% of PH patients exhibiting hyperuricemia (P<0.001 compared to control's 15.38%). The PH group demonstrated significantly elevated red blood cell distribution width (RDW)-standard deviation (50.59±6.49 43.67±3.40 fL, P<0.001) and RDW-coefficient of variation of (16.18%±3.04% 13.52%±1.32%, P<0.001), along with a decreased platelet level compared to the control group [(202.55±73.67) (256.63±72.85) ×10/L]. Furthermore, echocardiographic indicators related to right heart function showed correlations with red blood cell count, bilirubin, albumin, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol (multiple significant correlation coefficient r, magnitude from 0.22 to 0.54).
Chronic pulmonary disease and left heart disease were identified as common etiologies of PH among Tibetan patients residing in high-altitude regions. The Tibetan population residing in high-altitude regions and diagnosed with PH displayed abnormal changes in numerous liver functional and metabolic indices, which were correlated with the morphological indices observed via cardiac ultrasound.
肺动脉高压(PH)是一个严重的健康问题,其特征为肺动脉血压升高,而关于藏族人群中PH临床特征的数据有限。本研究的目的是调查居住在西藏昌都察雅县的藏族人群中PH患者的临床特征。
这是一项回顾性横断面研究。纳入了2019年3月至2020年10月期间在西藏昌都察雅县人民医院内科通过超声心动图诊断的94例PH患者。此外,选择52例非PH住院患者作为对照组。查阅患者病历以获取人口统计学和临床数据、实验室检查结果及超声心动图检查结果。采用PH组与对照组之间的t检验/卡方检验、对照组与PH亚组之间的单因素方差分析(ANOVA)、Pearson相关系数和Spearman相关系数对结果进行分析。
在内科的1689例住院患者中,94例被确定为PH患者进行分析。PH患者的平均血红蛋白水平(150.64±21.67 g/L)与高海拔地区正常人群(146.65±17.51 g/L)相似(P=0.28)。观察到肝功能指标异常,51.06%的PH患者出现高尿酸血症(与对照组的15.38%相比,P<0.001)。PH组的红细胞分布宽度(RDW)标准差(50.59±6.49对43.67±3.40 fL,P<0.001)和RDW变异系数(16.18%±3.04%对13.52%±1.32%,P<0.001)显著升高,且与对照组相比血小板水平降低[(202.55±73.67)对(256.63±72.85)×10/L]。此外,与右心功能相关的超声心动图指标与红细胞计数、胆红素、白蛋白、低密度脂蛋白胆固醇和高密度脂蛋白胆固醇相关(多个显著相关系数r,范围从0.22至0.54)。
慢性肺部疾病和左心疾病被确定为居住在高海拔地区的藏族患者中PH的常见病因。居住在高海拔地区且被诊断为PH的藏族人群表现出许多肝功能和代谢指标的异常变化,这些变化与通过心脏超声观察到的形态学指标相关。