呼吸科住院肺动脉高压患者病因构成及肺动脉压力相关因素分析

Analysis of etiology and related factors of pulmonary arterial pressure in hospitalized patients with pulmonary hypertension

目的探讨肺动脉高压(PH)患者病因构成,分析其临床特点及肺动脉压力的相关因素。方法收集经胸超声心动图诊断为PH的住院患者127例,根据2008年Dana Point PH分类方法分析PH患者的病因构成、临床特点及肺动脉压力的相关因素。结果 PH患者的病因构成依次为肺部疾病和(或)低氧者97例(76.38%)、左心疾病和慢性血栓栓塞各10例(7.87%)、动脉型肺动脉高压(PAH)8例(6.31%)、原因不明者2例(1.57%)。肺部疾病和(或)低氧所致PH中以慢性阻塞性肺病(COPD)最常见,为65例(67.01%)。PH患者的最常见症状是咳嗽113例(88.98%),最常见并发症是呼吸衰竭68例(53.54%)。直线相关分析提示肺动脉收缩压(PASP)与红细胞计数(RBC)、血红蛋白浓度(HGB)、尿酸(UA)呈正相关(r分别为0.356、0.222、0.309,P<0.05),与PaO2呈负相关(r为-0.343,P<0.05)。结论呼吸科住院的PH患者病因构成多种多样,肺部疾病和(或)低氧者最多见,咳嗽、咳痰、呼吸困难是常见的症状,PaO2、UA、RBC、HGB与肺动脉压力的高低有一定关系。

Objective To explore the etiology composition of pulmonary hypertension（ PH） inpatients and analysis their clinical features and related factors with pulmonary arterial pressure. Methods According to the newest amended PH classification in 2008, the etiology composition of the 127 PH inpatients who are diagnosed by Doppler echocardiography,their clinical characters and related factors of pulmonary arterial pressure were analyzed. Results Of all the 127 inpatients,76. 38% PH were owing to lung diseases and / or hypoxia,7. 87% PH from thrombotic or embolic disease,7. 87% from left heart disease,6. 31% from pulmonary arterial hypertension,and 1. 57% from unclear multifactorial mechanisms. Chronic obstructive pulmonary disease（ COPD） was the most frequent cause of the PH owing to lung diseases and / or hypoxia（ 67. 01%）. The most common clinical symptom was cough（ 88. 98%）. The most common complication was respiratory failure（ 53. 54%）. Linear correlation analysis showed that pulmonary arterial systolic pressure（ PASP） was positively correlated to the course of disease,red blood cell count（ RBC）,hemoglobin（ HGB） as well as uric acid（ UA）（ r value was 0. 356,0. 222and 0. 309 respectively,all P 0. 05） and negatively correlated with arterial partial pressure of oxygen（ PaO 2）（ r =-0343,P 0. 01）. Conclusion The etiology of PH inpatients of department of respiratory medicine are various and lung diseases and / or hypoxia are the most common cause. The common clinical symptom is cough,expectoration and dyspnea. PaO 2,UA, RBC and HGB have some relationship with the severity of PH.