Masuyama J, Yoshio T, Takeda A, Shiina A, Kano S
Division of Clinical Immunology, Jichi Medical School, Tochigi.
Ryumachi. 1993 Feb;33(1):29-36.
To determine clinical and serological features that are related with the prognosis of connective tissue diseases with pulmonary hypertension (PH), we studied a long-term prognosis of 14 patients (4 SLE, 1 PSS, 3 MCTD, 2 primary Sjögren's syndrome, and 5 OL) accompanied by PH. The patients were divided into three groups; group A (4 cases) that is alive for 5-12 years until present, group B (6 cases) in which PH was the main cause of death, and group C (4 cases) was dead of pulmonary fibrosis and pericardial tamponade. No significant difference was observed in background connective tissue diseases among the three groups. However, the mean ages at the onset of PH was obviously younger in group B (25.7 yrs.) than both in group A (38.3 yrs.) and in group C (42.0 yrs.) (group A vs group B, p < 0.02, and group B vs group C, p < 0.05). Sudden death occurred in 5 of the 6 in group B, whereas it was not observed either in group A or in group C. Also, the interval between onset of PH and death was shorter in group B (1.3 yrs.) than in group C (3.5 yrs.). The incidence of digital necrosis and pericardial effusion was higher in group B (83% and 83%, respectively) than both in group A (0% and 25%, respectively) and in group C (25% and 40%, respectively). A large amount of pericardial effusion was detected in 4 of 5 cases in group B. The incidence of digital necrosis between group A and group B was significantly different (p < 0.05, Fisher's test).(ABSTRACT TRUNCATED AT 250 WORDS)
为了确定与结缔组织病合并肺动脉高压(PH)预后相关的临床和血清学特征,我们研究了14例合并PH的患者(4例系统性红斑狼疮、1例系统性硬化症、3例混合性结缔组织病、2例原发性干燥综合征和5例重叠综合征)的长期预后。患者被分为三组:A组(4例)至今存活5 - 12年;B组(6例),PH是主要死因;C组(4例)死于肺纤维化和心包填塞。三组患者的基础结缔组织病无显著差异。然而,B组PH发病时的平均年龄(25.7岁)明显低于A组(38.3岁)和C组(42.0岁)(A组与B组比较,p < 0.02;B组与C组比较,p < 0.05)。B组6例中有5例猝死,而A组和C组均未观察到猝死。此外,B组从PH发病到死亡的间隔时间(1.3年)短于C组(3.5年)。B组指端坏死和心包积液的发生率(分别为83%和83%)高于A组(分别为0%和25%)和C组(分别为25%和40%)。B组5例中有4例检测到大量心包积液。A组和B组之间指端坏死的发生率有显著差异(p < 0.05,Fisher检验)。(摘要截断于250字)