慢性栓塞性肺动脉高压的误诊分析

Misdiagnostic Analysis in Sixty-five Patients With Chronic Thrombecmbolic Pulmonary Hypertension

目的：为提高对慢性栓塞性肺动脉高压（CTEPH）的认识和诊断。方法：回顾性分析72例慢性栓塞性肺动脉高压患者中，65例在院外被误诊为其它心肺疾病的临床资料。结果：院外误诊率为90．28％，共误诊97例次（有的患者曾误诊多种疾病），误诊的情况为原发性肺动脉高压22例次（22．68％）、冠心病18例次（18．56％）、先天性心脏病16例次（16．49％）、心肌炎10例次（10．31％）、心肌病9例次（9．28％）、风湿性心脏病5例次（5．15％）、心包炎2例次（2．06％）及肺部疾病15例次（15．46％）。结论：CTEPH误诊率极高，临床医师应提高对CTEPH的认识，减少误诊。

Objective:To improve the identification of chronic thromboembolic pulmonary hypertension (CTEPH) by means of themisdiagnostic analysis.Methods:The misdiagnostic condition before admission were restrospectively analysed in 72 cases of CTEPH.Results: Sixty-five cases of them were misdiagnosed (90. 28%) as primary pulmonary hypertension in 22 times(22.68% ),coronary heart disease in 18 times (18. 56 % ),congenital heart diseases in 16 times (16. 49 % ), myocarditis in 10times (10. 31 % ),cardiomyopathy in 9 times (9. 28% ),rheumatic heart disease in 5 times (5. 51 % ),pericarditis in 2 times(2. 06% ) and pulmonary diseases in 15 times (15. 46 % ). The total was 97 times.Conclusion: The misdiagnostic rate of CTEPH is too high to be accepted, so the clinicians must be familiar with the clinical manifestation of CTEPH to reduce its misdiagnosis.