眉山地区肺动脉高压患者病因构成及住院转归研究

Etiological composition and hospitalization outcome of patients with pulmonary arterial hypertension in Meishan area

目的 探讨肺动脉高压患者病因构成并分析其住院转归情况。方法 以2019年1月至2021年12月眉山地区3家医院收治的肺动脉高压患者为研究对象,根据患者病历资料及诊断结果,按照2008年Dana Point肺动脉高压分类法分析肺动脉高压患者病因构成;对患者特征及住院转归情况进行分析,并采用单、多因素分析方法对患者住院转归影响因素进行分析。结果 共纳入1 748例肺动脉高压患者资料进行分析,动脉型肺动脉高压624例(35.70%)、左心疾病相关肺动脉高压811例(46.40%)、呼吸系统疾病或缺氧相关性肺动脉高压286例(16.36%)、慢性血栓性肺动脉高压23例(1.32%)、原因不明或多种因素所致肺动脉高压4例(0.23%)。性别、年龄及年份不同的肺动脉高压患者病因分布差异均有统计学意义(均P<0.01)。1 295例(74.08%)转归良好,453例(25.92%)转归不良(放弃治疗或死亡)。多因素Logistic回归分析结果显示,女性(OR=4.436)、年龄增长(OR=7.396)、病因为动脉型(OR=2.349)、左心疾病相关(OR=1.689)及呼吸系统疾病或缺氧相关(OR=1.379)、肺动脉高压分级升高(OR=1.499)、病程>60个月(OR=3.747)、有并发症(OR=2.149)、Pa O2异常(OR=2.654)以及Pa CO_(2)异常(OR=1.319)是肺动脉高压患者住院转归不良的危险因素。结论 肺动脉高压患者多发于41~50岁人群,其中女性多见,动脉型肺动脉高压和左心疾病相关肺动脉高压是肺动脉高压最常见病因。肺动脉高压患者转归不良发生率较高,且不同特征的患者住院转归存在明显差异。

ObjectiveTo investigate the etiological composition of patients with pulmonary arterial hypertension(PAH)and to analyze their hospitalization outcome.MethodsPAH patients admitted to the 3 hospitals in Meishan area from January 2019 to December 2021 were enrolled in the study,and the etiological composition of PAH patients was ana-lyzed according to the 2008 Dana Point Classification of PAH based on patient medical record data and diagnosis.The char-acteristics and hospitalization outcomes of the patients were analyzed,and the influencing factors of the hospitalization out-come were analyzed by univariate and multivariate analysis methods.ResultsA total of 1748 PAH patients were includ-ed for analysis.There were 624 cases(35.70%)of arterial PAH,811 cases(46.40%)of left heart disease-related PAH,286 cases(16.36%)of respiratory diseases or hypoxia-related PAH,23 cases(1.32%)of chronic thrombotic PAH,and 4 cases(0.23%)of PAH caused by unknown causes or multiple factors.There were statistically significant differences in the etiological distribution of PAH patients with different gender,ages,and years(all P<0.01).There were 1295 cases(74.08%)of good outcomes and 453 cases(25.92%)of adverse outcomes(including the abandonment of treatment or death).Multivariate Logistic regression analysis showed that the risk factors affecting the adverse outcomes of PAH pa-tients were female(OR=4.436),age increase(OR=7.396),the disease was associated with the arterial type(OR=2.349),left heart disease(OR=1.689),and respiratory system disease or hypoxia(OR=1.379),the elevation of PAH grade(OR=1.499),course of disease>60 months(OR=3.747),complications(OR=2.149),abnormal PaO2(OR=2.654),and abnormal PaCO_(2)(OR=1.319).ConclusionsPAH is most common in patients aged 41 to 50 years and is more common in women.Arterial PAH and left heart disease-related PAH are the most common causes of PAH.The inci-dence of adverse outcomes in PAH patients is high,and there are significant differences in hospitalization outcomes among patients with different characteristics.