肺动脉高压对结缔组织病相关间质性肺病的预测意义

目的探讨肺动脉高压(PAH)对结缔组织病相关间质性肺病(CTD-ILD)的预测意义。方法依据有无合并PAH,将105例CTD-ILD患者分为PAH组17例和无PAH组88例。比较两组患者的肺功能、血气分析及超声心动图检查结果,分析PAH与ILD分型、临床、影像、生理(CRP)评分、胸部高分辨率CT(HRCT)评分的相关性及肺动脉收缩压(PASP)对CTD-ILD患者死亡率的预测价值。结果PAH组男性患者比例和一氧化碳弥散量占预计值的百分tk(DLCO%pred)均低于无PAH组,吸烟患者比例和PASP均高于无PAH组(P<0.05)。Pecm相关分析结果显示,PASP与CRP评分(r=1.60,P=0.330)、胸部HRCT评分均无相关性(r=0.15,P=0.379)。Cox回归分析结果显示,PASP与CTD-ILD患者的死亡率明显相关(HR=2.558,95%CI,1.48-5.703,P=0.022)。Kaplan-Meier曲线分析结果显示,PAH组患者的生存率明显低于无PAH组(P=0.015)。结论部分CTD-ILD患者可能合并PAH,PAH是影响CTD-ILD患者生存与预后的因素之一。

Predictive significance of pulmonary artery hypertension on connective tissue disease-associated interstitial lung disease

Objective To explore the predictive significance of pulmonary arterial hypertension (PAH) on connective tissue disease-associated interstitial lung disease(CTD-ILD). Methods A total of 105 patients with CTD-ILD were divided into PAH group (17 cases) and non-PAH group (88 cases) according to whether combined with PAH or not. Pulmonary function, results of blood gas assay and echocardiogram axamine were compared between two groups. Correlation of PAH with ILD type, Clinical, Radiographic and Physiological ( CRP) score, chest high resolution CT (HRCT) score and predictive significance of pulmonary artery systolic pressure (PASP) on mortality of patients with CTD-ILD were analyzed. Results Ratio of male patients and percentage of carbon monoxide dispersion/predictive value (DLCO%pred) was lower,ratio of patients who smoked and PASP was higher in PAH group than those in non-PAH group(P<0.05). Results of Person correlation analysis show that there were no significant differences of PASP with CRP score(r = 1.60,P =0.330) and chest HRCT score(r = 0.15,P =0.379). Results of Cox regression analysis showed that PASP was significantly associated with mortality in patients with CTD-ILD(r =2.558,95% CI,1.148 ~5.703 ,P = 0.022). Results of Kaplan-Meier curve analysis showed that the survival rate of patients in PAH group was significantly lower than that in non-PAH group (P =0.015). Conclusion Some patients with CTD-ILD may combined with PAH and PAH is one of the factors that affect the survival and prognosis of patients with CTD-ILD.