间质性肺疾病相关肺动脉高压患者肺动脉收缩压与肺功能指标的相关性研究

Correlation between Pulmonary Artery Systolic Pressure and Pulmonary Function Indexes in Patients with Interstitial Lung Disease Associated Pulmonary Hypertension

背景肺动脉高压(PH)是一种以肺动脉压升高为主要表现的病理生理状态,可由间质性肺疾病(ILD)引起。目前国内对间质性肺疾病相关肺动脉高压(ILD-PH)患者PH与肺功能相关性的研究很少。目的分析ILDPH患者肺动脉收缩压(PASP)与肺功能指标的相关性。方法回顾性选取2017年7月—2020年7月在南京医科大学附属无锡人民医院就诊的ILD患者202例为研究对象。根据患者是否发生PH,将其分为ILD-PH组(71例)和非ILD-PH组(131例)。收集并比较两组患者一般资料、PASP、肺功能指标,分析ILD-PH患者PASP与肺功能指标的相关性。结果ILD-PH组病程长于非ILD-PH组,尿酸(UA)、D-二聚体(D-D)、丙氨酸氨基转移酶(ALT)、脑钠肽(BNP)、PASP高于非ILD-PH组,血小板计数(PLT)、肺活量百分比(VC%)、第1秒用力呼气容积与用力肺活量比值(FEV_(1)/FVC)低于非ILD-PH组(P<0.05)。ILD-PH患者PASP与最大通气量(MVV)、VC%、用力肺活量占预计值百分比(FVC%)、FEV_(1)/FVC、残气量占肺总量百分比(RV/TLC%)、一氧化碳弥散量(DLCO)呈负相关(P值均<0.05)。结论ILD-PH患者PASP可能与肺功能指标(MVV、VC%、FVC%、FEV_(1)/FVC、RV/TLC%、DLCO)呈负相关。

Background Pulmonary hypertension(PH)is a pathophysiological state characterized by increased pulmonary artery pressure,which can be caused by interstitial lung disease(ILD).At present,there are few studies on the relationship between PH and pulmonary function in patients with interstitial lung disease associated pulmonary hypertension(ILD-PH).Objective To analyze the correlation between pulmonary artery systolic pressure(PASP)and pulmonary function indexes in patients with ILD-PH.Methods A total of 202 patients with ILD who were treated in Wuxi People's Hospital Affiliated to Nanjing Medical University from July 2017 to July 2020 were retrospectively selected as the research objects.According to whether the patients had PH,they were divided into ILD-PH group(71 cases)and non-ILD-PH group(131 cases).The general data,PASP and pulmonary function indexes of the two groups were collected and compared,and the correlation between PASP and pulmonary function indexes in ILD-PH patients was analyzed.Results The disease course of ILD-PH group was longer than that of non-ILD-PH group,uric acid(UA),D-dimer(D-D),alanine aminotransferase(ALT),brain natriuretic peptide(BNP),and PASP were higher than those of non-ILD-PH group,platelet count(PLT),vital capacity percentage(VC%),and the percentage of forced expiratory volume in the first second/forced vital capacity(FEV_(1)/FVC)were lower than those in the non-ILD-PH group(P<0.05).In patients with ILD-PH,PASP was negatively correlated with maximum ventilation(MVV),VC%,forced vital capacity as a percentage of predicted value(FVC%),FEV_(1)/FVC,residual volume as a percentage of total lung volume(RV/TLC%),carbon monoxide diffusion(DLCO)(P values were all<0.05).Conclusion PASP in ILD-PH patients may be negatively correlated with pulmonary function indexes(MVV,VC%,FVC%,FEV_(1)/FVC,RV/TLC%,and DLCO).