中华地方病学杂志
中華地方病學雜誌
중화지방병학잡지
Chinese Journal of Endemiology
2014年
1期
96-98
,共3页
姜亦瑶%蒋萍萍%杜振宗%刘晓程
薑亦瑤%蔣萍萍%杜振宗%劉曉程
강역요%장평평%두진종%류효정
地中海贫血%高血压,肺%回顾性研究
地中海貧血%高血壓,肺%迴顧性研究
지중해빈혈%고혈압,폐%회고성연구
Thalassemia%Hypertension,pulmonary%Retrospective studies
目的 回顾性分析珠蛋白生成障碍性贫血(TM)合并肺动脉高压(PH)患者的治疗及随访结果,探讨PH对TM的影响.方法 选择2007年6月至2011年7月天津医科大学心血管病临床学院及桂林医学院附属医院收治的TM合并PH患者19例作为病例组,同时选取性别、年龄相匹配的单纯TM患者22例作为对照组,观察血红蛋白(Hb)、乳酸脱氢酶(LDH)、血清铁蛋白(SF)、三尖瓣返流速度(TRV)、左心室射血分数(LVEF)等临床指标,并进行生存随访4～ 24个月.结果 病例组SF[(693.6土2346)μg/L]、TRV[(2.6±0.1)m/s]显著高于对照组[(209.5±100.1)μg/L、(2.1±0.3)m/s,t值分别为10.79、8.92,P均＜0.05],而两组之间Hb[(90.8±10.7)、(89.3±10.5)g/L]、LDH[(320.9±103.7)、(355.8±140.3)U/L]及LVEF[(66.2±7.1)％、(64.2±4.7)％]比较,差异均无统计学意义(t值分别为0.44、0.50、1.05,P均＞0.05);经生存分析Logrank检验,病例组预后较差(x2=4.95,P＜ 0.05);多元线性回归分析提示,年龄、SF与TRV有关,其中SF对TRV影响较大.结论 TM合并PH患者的预后较差,年龄及SF含量与PH的发展有关.
目的 迴顧性分析珠蛋白生成障礙性貧血(TM)閤併肺動脈高壓(PH)患者的治療及隨訪結果,探討PH對TM的影響.方法 選擇2007年6月至2011年7月天津醫科大學心血管病臨床學院及桂林醫學院附屬醫院收治的TM閤併PH患者19例作為病例組,同時選取性彆、年齡相匹配的單純TM患者22例作為對照組,觀察血紅蛋白(Hb)、乳痠脫氫酶(LDH)、血清鐵蛋白(SF)、三尖瓣返流速度(TRV)、左心室射血分數(LVEF)等臨床指標,併進行生存隨訪4～ 24箇月.結果 病例組SF[(693.6土2346)μg/L]、TRV[(2.6±0.1)m/s]顯著高于對照組[(209.5±100.1)μg/L、(2.1±0.3)m/s,t值分彆為10.79、8.92,P均＜0.05],而兩組之間Hb[(90.8±10.7)、(89.3±10.5)g/L]、LDH[(320.9±103.7)、(355.8±140.3)U/L]及LVEF[(66.2±7.1)％、(64.2±4.7)％]比較,差異均無統計學意義(t值分彆為0.44、0.50、1.05,P均＞0.05);經生存分析Logrank檢驗,病例組預後較差(x2=4.95,P＜ 0.05);多元線性迴歸分析提示,年齡、SF與TRV有關,其中SF對TRV影響較大.結論 TM閤併PH患者的預後較差,年齡及SF含量與PH的髮展有關.
목적 회고성분석주단백생성장애성빈혈(TM)합병폐동맥고압(PH)환자적치료급수방결과,탐토PH대TM적영향.방법 선택2007년6월지2011년7월천진의과대학심혈관병림상학원급계림의학원부속의원수치적TM합병PH환자19례작위병례조,동시선취성별、년령상필배적단순TM환자22례작위대조조,관찰혈홍단백(Hb)、유산탈경매(LDH)、혈청철단백(SF)、삼첨판반류속도(TRV)、좌심실사혈분수(LVEF)등림상지표,병진행생존수방4～ 24개월.결과 병례조SF[(693.6토2346)μg/L]、TRV[(2.6±0.1)m/s]현저고우대조조[(209.5±100.1)μg/L、(2.1±0.3)m/s,t치분별위10.79、8.92,P균＜0.05],이량조지간Hb[(90.8±10.7)、(89.3±10.5)g/L]、LDH[(320.9±103.7)、(355.8±140.3)U/L]급LVEF[(66.2±7.1)％、(64.2±4.7)％]비교,차이균무통계학의의(t치분별위0.44、0.50、1.05,P균＞0.05);경생존분석Logrank검험,병례조예후교차(x2=4.95,P＜ 0.05);다원선성회귀분석제시,년령、SF여TRV유관,기중SF대TRV영향교대.결론 TM합병PH환자적예후교차,년령급SF함량여PH적발전유관.
Objective To analyze the clinical feature of thalassemia with pulmonary hypertension and investigate the influence of pulmonary hypertension on thalassemia.Methods From June 2007 to July 2011,clinical data of 19 patients with thalassemia complicated with pulmonary hypertension in TEDA International Cardiovascular Hospital of Tianjin Medical University and Affilated Hospital of Guilin Medical College were analyzed retrospectively.Twenty-two cases of thalassemia without pulmonary hypertension were as a control group,and follow-up time was set as 4 months to 24 months.Observed indicators included age,hemoglobin(Hb),lactate dehydrogenase (LDH),serum ferritin (SF),tricuspid regurgitation velocity (TRV) and left ventricular ejection fraction (LVEF).Results SF and TRV of the case group[(693.6 ± 234.6)μg/L and (2.6 ± 0.1)m/s] were significantly higher than those of the control [(209.5 ± 100.1) μg/L and (2.1 ± 0.3)m/s,all P ＜ 0.05]; but the differences between case and control group in Hb[(90.8 ± 10.7)g/L vs (89.3 ± 10.5)g/L],LDH[(320.9 ± 103.7)U/L vs (355.8 ± 140.3)U/L] and LVEF[(66.2 ± 7.1)％ vs (64.2 ± 4.7)％] were not statistically significant (all P ＞ 0.05).Logrank analysis showed that the prognosis was poor in patients with thalassemia complicated with pulmonary hypertension (x2 =4.95,P ＜ 0.05).Multiple regression analysis indicated that age and serum ferritin remained as predisposing risk factors for tricuspid regurgitation velocity,and serum ferritin had a greater impact on the velocity.Conclusion In patients with thalassemia complicated with pulmonary hypertension,the prognosis is poor; age and SF may be factors involved in the development of pulmonary hypertension.
