两类毛细血管后性肺高血压的临床特征比较

Comparison of clinical characteristics between two types of post-capillary pulmonary hypertension

目的分析单纯毛细血管后性肺高血压(isolated post-capillary pulmonary hypertension,IPC-PH)与混合性毛细血管后性肺高血压(combined post-and pre-capillary pulmonary hypertension,CPC-PH)患者的临床特征,为毛细血管后性肺高血压的临床管理提供参考。方法共选取经Swan-Ganz漂浮导管确诊为毛细血管后性肺高血压患者163例,根据血流动力学特征将其分为IPC-PH和CPC-PH两组。收集患者一般资料、超声心动图及Swan-Ganz漂浮导管检查结果并进行对比。结果CPC-PH组患者血尿酸、肺动脉收缩压、肺动脉舒张压、肺动脉平均压均显著高于IPC-PH组患者,而体重、三酰甘油、主动脉根内径、心输出量、每搏输出量、心指数均明显小于IPC-PH组患者(P均<0.05)。结论通过血尿酸、肺动脉收缩压、肺动脉舒张压、肺动脉平均压、心输出量、每搏输出量、心指数等指标,可对CPC-PH与IPC-PH加以鉴别。

Objective To analyze the clinical characteristics of patients with isolated post-capillary pulmonary hypertension(IPC-PH)and combined post-and pre-capillary pulmonary hypertension(CPC-PH),and to provide references for the clinical management of post-capillary pulmonary hypertension.Methods A total of 163 patients diagnosed with post-capillary pulmonary hypertension by Swan-Ganz floating catheter were selected,and divided into IPC-PH and CPC-PH groups according to their hemodynamic characteristics.General data,and examination results of echocardiography and Swan-Ganz floating catheter were collected and compared.Results The serum uric acid,pulmonary artery systolic and diastolic blood pressure,and mean pulmonary artery pressure in the CPC-PH group are significantly higher than those in the IPC-PH group,while the body weight,triglyceride,aortic root diameter,cardiac output,stroke volume and cardiac index in the CPC-PH group are significantly lower than those in the IPC-PH group(P<0.05).Conclusion CPC-PH can be distinguished from IPC-PH by blood uric acid,pulmonary artery systolic and diastolic blood pressure,mean pulmonary artery pressure,cardiac output,stroke volume,cardiac index,etc.