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《天津医科大学学报》[ISSN:1006-8147/CN:12-1259/R]

卷:

26卷

期数:

2020年04期

页码:

346-349

栏目:

临床医学

出版日期:

2020-07-15

文章信息/Info

Title:

Clinical feature analysis of pericardial effusion in patients with connective tissue disease associated pulmonary arterial hypertension

文章编号:

1006-8147(2020)04-0346-04

作者:

王慧¹; 张娜¹; 刘永玉²; 吴秀华¹; 赵音¹; 杨振文³; 曹洁⁴; 董丽霞⁴; 魏蔚¹

（1.天津医科大学总医院风湿免疫科，天津 300052；2.天津医科大学教务处，天津 300070；3.天津医科大学总医院心脏科，天津 300052；4.天津医科大学总医院呼吸科，天津 300052）

Author(s):

WANG Hui¹;  ZHANG Na¹;  LIU Yong-yu²;  WU Xiu-hua¹;  ZHAO Yin¹;  YANG Zhen-wen³;  CAO Jie⁴;  DONG Li-xia⁴;  WEI Wei¹

（1.Department of Rheumatology and Immunology，General Hospital，Tianjin Medical University， Tianjin 300052，China；2.Office of Academic Affairs，Tianjin Medical University，Tianjin 300070，China；3.Department of Cardiology，General Hospital， Tianjin Medical Univer

关键词:

结缔组织病; 肺动脉高压; 右心导管; 心包积液

Keywords:

connective tissue disease;  pulmonary arterial hypertension;  right heart catheterization;  pericardial effusion

分类号:

R593.2

DOI:

-

文献标志码:

A

摘要:

目的：探讨心包积液与结缔组织病相关肺动脉高压（CTD-PAH）病情的关系。方法：回顾性分析经右心导管检查诊断的61例CTD-PAH患者的临床资料，根据超声心动图结果分为有心包积液组（n=33）和无心包积液组（n=28），比较两组的年龄、世界卫生组织心功能分级（WHO Fc）、免疫及炎症指标、超声心动图及右心导管检查结果的差异。分析心包积液量与免疫炎症指标、心功能指标等的相关性。结果：61例患者男女比例为1:60，平均年龄（43.4±14.6）岁。心包积液组较无心包积液组血尿酸[（402.8±125.0）μmmol/L vs.（326.2±103.4）μmmol/L，P <0.05]、N末端B型利钠肽原[（1 345.5±1 167.5）pg/mL vs.（326.4±458.1）pg/mL，P<0.05]、平均右心房压[（6.8±4.1）mmHg vs.（4.9±2.1）mmHg，P<0.05]、右心室舒张末压[（10.6±3.8）mmHg vs.（8.5±3.6）mmHg，P<0.05]、右心房舒张末期横径[（49.5±6.4）mm vs.（41.8±7.6）mm，P<0.05]、右心室舒张末期横径[（43.0±5.5）mm vs.（36.9±8.2）mm，P<0.05]及肺动脉收缩压[（89.5±23.0）mmHg vs.（74.4±23.6）mmHg，P <0.05]更高。心包积液量与血尿酸、NT-proBNP、mRAP、RVEDP、RAD及RVD值呈正相关（r=0.31、0.54、0.28、0.36、0.40、0.33，均P<0.05）。SLE病情活动的患者较病情相对缓解的患者出现心包积液的比例更高[（16/24）vs.（2/6），P =0.14]。结论：心包积液是CTD-PAH患者常见的临床表现，可能与右心功能相关。

Abstract:

Objective: To investigate the relationship between pericardial effusion and connective tissue disease-associated pulmonary arterial hypertension(CTD-PAH). Methods: The clinical data of 61 patients with CTD-PAH diagnosed by right heart catheterization in the General Hospital of Tianjin Medical University from October 2008 to May 2016 were retrospectively analyzed.According to the results of echocardiography, these patients were divided into pericardial effusion group (n=33) and non-pericardial effusion group (n=28), and the age, WHO Fc, immune and inflammation indicators of the two groups were compared.Echocardiography and right heart catheterization results were compared. The correlation between the volume of pericardial effusion and the indexes of immune inflammation and cardiac function were analyzed. Results：The ratio of male to female in 61 patients was 1:60, with an average age of(43.4±14.6) years. Pericardial effusion group had higher blood uric acid[(402.8±125.0)μmmol/L vs.(326.2±103.4) μmmol/L, P <0.05], N-terminal B-type natriuretic peptide[(1 345.5±1 167.5)pg/mL vs.(326.4±458.1)pg/mL, P <0.05], mean right atrial pressure[(6.8±4.1)mmHg vs(4.9±2.1)mmHg, P<0.05], right ventricular end-diastolic pressure[(10.6±3.8)mmHg vs.(8.5±3.6)mmHg, P<0.05], right atrial end-diastolic transverse diameter[(49.5±6.4)mm vs.(41.8±7.6)mm, P <0.05], right ventricle end-diastolic transverse diameter[(43.0±5.5)mm vs.(36.9±8.2)mm, P <0.05] and systolic pulmonary artery pressure[(89.5±23.0)mmHg vs.(74.4±23.6)mmHg, P <0.05] than those without pericardial effusion(P <0.05). The degree of pericardial effusion was positively correlated with serum uric acid, N-terminal B-type natriuretic peptide, mean right atrial pressure,right ventricular end-diastolic pressure, right atrial end-diastolic transverse diameter and right ventricle end-diastolic transverse diameter(r=0.31, 0.54, 0.28, 0.36, 0.40, 0.33, all P <0.05). SLE patients with higher disease activity index were more likely to have pericardial effusions than patients with disease relative remission[(16/24) vs.(2/6), P=0.14]. Conclusion: Pericardial effusion is a common clinical manifestation in patients with CTD-PAH and may be related to right heart function.

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相似文献/References:

[1]刘丽美,李宝娟,魏丽萍.高原地区肺动脉高压的相关危险因素分析[J].天津医科大学学报,2021,27(01):32.
　LIU Li-mei,LI Bao-juan,WEI Li-ping.Analysis of risk factors for pulmonary arterial hypertension in high-altitude areas[J].Journal of Tianjin Medical University,2021,27(04):32.
[2]刘罩明,刘宇,扎西拉宗,等.超声诊断心肌致密化不全伴左心室血栓1例[J].天津医科大学学报,2024,30(03):267.[doi:10.20135/j.issn.1006-8147.2024.03.0267]

备注/Memo

备注/Memo:

作者简介 王慧（1990-），女，住院医师，硕士，研究方向：风湿病；
通信作者：魏蔚，E-mail：tjweiwei2003@163.com。

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更新日期/Last Update: 2020-07-15