| 引用本文： |
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陈天翔,吴粤,王瑛,等.心肺运动试验参数的性别差异对特发性肺动脉高压患者无事件生存率的影响[J].同济大学学报（医学版）,2018,39(2):66-72. [点击复制]
- CHEN Tian-xiang,WU Yue,WANG Ying,et al.Gender-specific cardiopulmonary exercise testing parameters impact on event-free survival in patients with idiopathic pulmonary arterial hypertension[J].同济大学学报（医学版）,2018,39(2):66-72. [点击复制]
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| 摘要: |
| 目的研究特发性肺动脉高压（idiopathic pulmonary arterial hypertension, IPAH）患者性别特异的心肺运动试验（cardiopulmonary exercise testing, CPET）参数对无事件生存率的影响。
方法回顾性纳入2010年5月至2016年4月同济大学附属肺科院肺循环科初次住院的IPAH患者，共56例（男性21例，女性35例），按照有无恶化事件发生进行亚组分析。所有患者均进行了右心导管检查及CPET。多因素Cox比例风险分析预测发生临床恶化事件的独立预测因素，受试者工作特征曲线确定各独立预测因素的阈值。结果男性及女性IPAH患者的一般临床资料及血流动力学指标差异无统计学意义。与女性患者相比，男性患者具有较高的peak VE，PETO2 at AT，peak PETO2以及较低的peak VO2/VE及PETCO2 at AT。亚组分析中，男性event组的peak workload显著低于无事件组；而peak O2 pulse则在女性患者event组中降低。此外，event组男性相较于女性显示出较高的peak VE，Nadir VE/VCO2，PETO2 at AT和peak PETO2，而peak VO2/VE，PETCO2 at AT和peak PETCO2则降低。peak PETCO2和peak O2 pulse分别是预测男性和女性IPAH患者无事件生存率的独立预后因素。结论CPET参数中用于预测IPAH患者无事件生存率的独立预测因素体现出显著的性别差异，或许可以用不同CPET参数进一步研究IPAH患者在发病机制、个体化治疗及预测临床结局上的价值。 |
| 关键词: 特发性肺动脉高压 心肺运动试验 性别差异 |
| DOI：10.16118/j.1008-0392.2018.02.013 |
| 投稿时间：2017-09-15 |
| 基金项目:国家自然科学基金（81500040） |
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| Gender-specific cardiopulmonary exercise testing parameters impact on event-free survival in patients with idiopathic pulmonary arterial hypertension |
| CHEN Tian-xiang,WU Yue,WANG Ying,YUAN Ping,LIU Jin-ming |
| (Dept. of Pulmonary Circulation, Pulmonary Hospital, Tongji University, Shanghai 200433, China;Dept. of Clinical Laboratory, Pulmonary Hospital, Tongji University, Shanghai 200433, China) |
| Abstract: |
| ObjectiveTo investigate the effects of gender-specific cardiopulmonary exercise testing (CPET) parameters on the event-free survival in patients with idiopathic pulmonary arterial hypertension (IPAH). MethodsFifty-six IPAH patients aged >18 years including 21 males and 35 females, who underwent right-heart catheterization (RHC) and CPET in Shanghai Pulmonary Hospital from May 2010 to April 2016, were recruited. The multivariate Cox-proportional hazards analysis was performed to assess the prognostic value of CPET, and the receiver operating characteristics (ROC) curve was used to determine the cut-off value. ResultsNo significant differences were found in demographic and hemodynamic parameters between male and female patients. Male patients had higher peak VE, PETO2 at AT, peak PETO2 and lower peak VO2/VE and PETCO2 at AT. Peak workload was significant lower in males with events, while peak O2 pulse declined in females with events group. Male with events had higher peak VE, Nadir VE/VCO2, PETO2 at AT and peak PETO2, compared to females with events, while peak VO2/VE, PETCO2 at AT and peak PETCO2 were much lower. Peak PETCO2and peak O2 pulse were independent predictors of event-free survival in males and females, respectively. ConclusionGender may influence CPET parameters for predicting clinical severity of IPAH, suggesting that different CPET parameters should be used for study of pathogenesis, individualized treatment and predicting clinical outcomes for IPAH patients of different genders. |
| Key words: idiopathic pulmonary arterial hypertension cardiopulmonary exercise testing gender difference |
