摄氧效率斜率预测特发性肺动脉高压预后

发布时间：2019-02-27 07:05

【摘要】：目的:评价摄氧效率斜率能否独立预测特发性肺动脉高压预后。方法:前瞻性连续入组2010-11到2015-06阜外医院新诊断特发性肺动脉高压患者,对患者进行定期随访,记录患者心血管事件(死亡和肺移植)。采用Kaplan-Meier曲线、单因素和多因素Cox比例风险回归模型进行生存分析。结果:210例特发性肺动脉高压患者完成了心肺运动试验并接受了定期随访,女性159例(75.7%)。在平均随访41个月后,31例患者出现死亡,1例患者接受肺移植。摄氧效率斜率与峰值摄氧量/体重呈明显正相关(r=0.71,P0.0001)。多因素分析表明摄氧效率斜率指数和N末端B型利钠肽原(NT-pro BNP)可以独立预测患者预后。摄氧效率斜率指数≤0.52L/(min·m~2)患者5年生存率明显低于摄氧效率斜率指数0.52L/(min·m~2)的患者(41.9%vs89.8%,P0.0001)。结论:摄氧效率斜率作为一个亚极量心肺运动试验指标,可以很好的预测特发性肺动脉高压患者预后。
[Abstract]:Objective: to evaluate whether the slope of oxygen uptake rate can independently predict the prognosis of idiopathic pulmonary hypertension. Methods: the patients with idiopathic pulmonary hypertension were prospectively enrolled from November 2010 to June 2015 in Fuwai Hospital. The patients were followed up regularly to record the cardiovascular events (death and lung transplantation). Kaplan-Meier curve, single-factor and multi-factor Cox proportional hazard regression model were used for survival analysis. Results: 210 patients with idiopathic pulmonary hypertension completed cardio-pulmonary exercise test and received regular follow-up, 159 women (75.7%). After an average follow-up of 41 months, 31 patients died and 1 patient received lung transplantation. The slope of oxygen uptake efficiency was positively correlated with the peak oxygen uptake / body weight (r = 0.71, P 0.0001). Multivariate analysis showed that oxygen uptake efficiency slope index and N-terminal B-type natriuretic peptide (NT-pro BNP) were independent predictors of prognosis. The 5-year survival rate of patients with slope index of oxygen uptake efficiency 鈮，

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