[1](程慧玲 许东旭 张浩 孙伟 盛燕辉 杨荣 张海锋 郑旭辉 周艳丽 姚文明 徐东杰 孔祥清 李新立）.肺动脉楔压大于15 mm Hg 的肺高血压病因分析[J].心血管病学进展,2020,(11):1199-1202.[doi:10.16806/j.cnki.issn.1004-3934.2020.11.000]
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肺动脉楔压大于15 mm Hg 的肺高血压病因分析()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年11期
页码:
1199-1202
栏目:
论著
出版日期:
2020-11-25

文章信息/Info

文章编号:
202005140
作者:
(程慧玲 许东旭 张浩 孙伟 盛燕辉 杨荣 张海锋 郑旭辉 周艳丽 姚文明 徐东杰 孔祥清 李新立）
(南京医科大学第一附属医院心内科,江苏 南京 210000)
Author(s):
?Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210000, Jiangsu, China)
关键词:
肺高血压; 左心疾病; 肺动脉楔压
Keywords:
Pulmonary hypertension;  Left heart disease;  Pulmonary artery wedge pressure
DOI:
10.16806/j.cnki.issn.1004-3934.2020.11.000
摘要:
目的 分析 肺动脉楔压＞15 mm Hg 的肺高血压患者的病因。 方法 入选147例经右心导管诊断的平均肺动脉压≥ 25 mm Hg和肺动脉楔压>15 mm Hg 的肺高血压患者，分析这些患者的临床所患疾病及超声心动图特点。 结果 在这些患者中，患有先天性心脏病的有18例（12.2%）、心肌病78例（53.1%）、高血压37例（25.2%）、冠心病17例（11.6%）和心房颤动37例（25.2%）。96 %的患者有左室射血分数＜50%或中度以上左心瓣膜病：左室射血分数＜40% 96例（65.3%），左室射血分数40%～49% 13例（8.8%），中度以上左心瓣膜病（主动脉狭窄、主动脉关闭不全、二尖瓣狭窄、二尖瓣关闭不全）的分别有4例（2.7%）、35例（23.8%）、9例（6.1%）和111例（75.5%）；最终分析结果表明在147例肺动脉楔压＞15 mm Hg 的肺高血压患者中，有18例（12.24%）的患者合并有先天性心脏病。 结论 在入选本研究的肺动脉楔压＞15 mm Hg 肺高血压患者中，病因学分析表明部分患者除了有左心疾病，同时合并有先天性心脏病。此外，心脏超声结果表明部分患者既无左室射血分数下降，也无中度以上左心瓣膜疾病。
Abstract:
Objective To analyze the etiology of pulmonary hypertension with pulmonary artery wedge pressure (PAWP)＞15 mm Hg. Methods A total 147 patients diagnosed by right heart catheterization with mean pulmonary artery pressure≥25 mm Hg and PAWP＞15 mm Hg were enrolled. The clinical characteristic and echocardiographic parameter were further analyzed. Results The etiology is shown as congenital heart disease (18 cases , 12.2%) , cardiomyopathy (78 cases, 53.1%), hypertension (37 cases, 25.2%), coronary atherosclerotic disease (17 cases, 11.6%) and atrial fibrillation ( 37 cases, 25.2%). 96% of these patients were diagnosed with left ventricular ejection fraction ( LVEF)＜50% or moderate-to-severe left-sided heart valvular disease, including 96 cases (65.3%) with LVEF＜40%, 13 cases (8.8%) with LVEF 40%～49%. Within moderate or severe left heart valvular disease, aortic stenosis, aortic regurgitation, mitral stenosis and mitral regurgitation respectively account for 4 cases (2.7%), 35 cases (23.8%), 9 cases (6.1%) and 111 cases (75.5%). Final results of our analysis indicate 18 cases (12.24%) were born with congenital heart disease. Conclusion Among the patients with PAWP＞15 mm Hg, the etiology analysis shows that a proportion of them with left heart disease simultaneously suffer congenital heart disease. In addition, echocardiographic results showed that some patients had neither decreased LVEF nor more than moderate left ventricular valve disease.

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更新日期/Last Update: 2021-02-04