【摘要】：目的:評價攝氧效率斜率能否獨立預(yù)測特發(fā)性肺動脈高壓預(yù)后。方法:前瞻性連續(xù)入組2010-11到2015-06阜外醫(yī)院新診斷特發(fā)性肺動脈高壓患者,對患者進行定期隨訪,記錄患者心血管事件(死亡和肺移植)。采用Kaplan-Meier曲線、單因素和多因素Cox比例風(fēng)險回歸模型進行生存分析。結(jié)果:210例特發(fā)性肺動脈高壓患者完成了心肺運動試驗并接受了定期隨訪,女性159例(75.7%)。在平均隨訪41個月后,31例患者出現(xiàn)死亡,1例患者接受肺移植。攝氧效率斜率與峰值攝氧量/體重呈明顯正相關(guān)(r=0.71,P0.0001)。多因素分析表明攝氧效率斜率指數(shù)和N末端B型利鈉肽原(NT-pro BNP)可以獨立預(yù)測患者預(yù)后。攝氧效率斜率指數(shù)≤0.52L/(min·m~2)患者5年生存率明顯低于攝氧效率斜率指數(shù)0.52L/(min·m~2)的患者(41.9%vs89.8%,P0.0001)。結(jié)論:攝氧效率斜率作為一個亞極量心肺運動試驗指標,可以很好的預(yù)測特發(fā)性肺動脈高壓患者預(yù)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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