天津医药

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原发性干燥综合征合并肺动脉高压的临床研究

范倩1,巩路2   

  1. 1. 天津医科大学总医院
    2. 天津医科大学总医院感染科
  • 收稿日期:2012-05-22 修回日期:2012-09-02 出版日期:2013-01-15 发布日期:2013-01-15
  • 通讯作者: 范倩

Clinical Study of Pulmonary Arterial Hypertension in Primary Sj?gren’s Syndrome

Lu GONG2   

  • Received:2012-05-22 Revised:2012-09-02 Published:2013-01-15 Online:2013-01-15

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摘要：

【摘要】 目的探讨原发性干燥综合征(pSS)并发肺动脉高压(PAH)的发生率、临床特点及筛查方法。方法对61例临床确诊为pSS的患者行彩色多普勒超声心动检查,应用三尖瓣反流速度来估测肺动脉收缩压(PASP),依据PAH诊断标准将其分为PAH组(10例)和非PAH组(51例),收集2组的临床资料、实验室检查、胸CT扫描和超声心动的检测结果并进行比较。结果 (1)61例pSS患者中并发PAH者占16.4%,PAH组中PASP为31~64mmHg,平均(40±9)mmHg,其中4例无任何与PAH相关的临床表现,PAH的发生与患者年龄、性别、病程无关。(2)患者的主要症状为发热、干咳、胸闷或胸痛、心悸、进行性呼吸困难、雷诺现象、胸腔积液和肺间质病变,PAH组雷诺现象、心悸、肺间质病变的发生率高于非PAH组(P<0.05),PAH组的补体C3水平低于非PAH组(P<0.05)。(3)PAH组瓣膜受累达100%,其中2例仅伴有右心系统扩大,3例同时出现左心和右心系统扩大,PAH组左房内径、右房内径、右室内径、肺动脉内径高于非PAH组(P<0.05或P<0.01)。结论 pSS并发PAH并不少见,患者即使无相应临床症状,也应行超声心动筛查,这对PAH的临床早期诊断和治疗十分重要。

关键词: 肺动脉高压, 干燥综合征, 彩色多普勒超声心动图, 雷诺现象, 间质性肺疾病

Abstract: [Abstract] Objective To explore the prevalence, cause and clinical features of Sj?gren’s Syndrome complicated with pulmonary arterial hypertension. Methods The data of 61 cases in my department with the diagnosis of pSS during November 2010 to April 2011 were collected. All the cases take ultrasonocardiograph. Results In this study, the prevalence of pSS-PAH is 16.4%. The occurrence of pulmonary arterial hypertension is associated with Raynaud’s phenomenon, dry cough, chest tightness or chest pain, progressive dyspnea, heart palpitations, interstitial lung disease or disease active. Conclusion pSS patients without clinical symptoms, they also should do UCG, which is important to early diagnosis and treatment.

Key words: pulmonary artrial hypertension, Sj?gren’s syndrome, color Doppler echocardiography, Raynaud’s phenomenon, interstitial lung disease