Nakanishi N, Kyotani S, Satoh T, Kunieda T
Department of Internal Medicine, National Cardiovascular Center, Osaka, Japan.
Nihon Kyobu Shikkan Gakkai Zasshi. 1997 Jun;35(6):589-95.
We examined pulmonary hemodynamics and long-term outcome in 78 consecutive patients with chronic pulmonary thromboembolism and pulmonary hypertension. These patient's ages ranged from 19 to 75 years; the mean was 51.0 +/- 13.8 years and there was no difference in sex distribution. Mean pulmonary-artery pressure (PAm) was 44 +/- 14 mmHg and total pulmonary resistance (TPR) was 1138 +/- 634 dyne.sec.cm-5. Overall five-year survival was 58.4%, but in patients whose PAm was below 30 mmHg, the outcomes were better: all of these patients survived for at least 5 years. In patients whose PAm was above 30 mmHg, no correlation was found between the outcome and the magnitude of PAm. We divided the patients into four subgroups according to their TPR: 500 dyne.sec.cm-5 (TPR, 500 > or = TPR < 1000 dyne.sec.cm-5, 1000 < or = TPR < 1500 dyne.sec.cm-5, and 1500 dyne.sec.cm-5 < or = TPR. The five-year survivals in these groups were 100%, 88.9%, 52.4%, and 40.0%, respectively. Outcome correlated with the magnitude of TPR. TPR was useful for predicting the outcome of chronic pulmonary thromboembolism.
我们对78例连续性慢性肺血栓栓塞症合并肺动脉高压患者的肺血流动力学及长期预后进行了研究。这些患者年龄在19岁至75岁之间；平均年龄为51.0±13.8岁，性别分布无差异。平均肺动脉压（PAm）为44±14 mmHg，总肺阻力（TPR）为1138±634达因·秒·厘米⁻⁵。总体五年生存率为58.4%，但PAm低于30 mmHg的患者预后较好：所有这些患者至少存活了5年。在PAm高于30 mmHg的患者中，未发现预后与PAm大小之间存在相关性。我们根据TPR将患者分为四个亚组：500达因·秒·厘米⁻⁵（TPR，500≥TPR＜1000达因·秒·厘米⁻⁵、1000≤TPR＜1500达因·秒·厘米⁻⁵和1500达因·秒·厘米⁻⁵≤TPR）。这些组的五年生存率分别为100%、88.9%、52.4%和40.0%。预后与TPR大小相关。TPR有助于预测慢性肺血栓栓塞症的预后。
