实用临床医药杂志2025，Vol.29Issue(24)：49-54,6.DOI:10.7619/jcmp.20253789
规律随访且治疗达标对结缔组织病相关肺动脉高压患者预后的影响
Influence of regular follow-up with treatment to target on prognosis of patients with connective tissue disease-associated pulmonary arterial hypertension
摘要
Abstract
Objective To investigate the impact of regular follow-up with treatment to target within one year on the prognosis of patients with connective tissue disease-associated pulmonary arteri-al hypertension(CTD-PAH).Methods A retrospective analysis was conducted on the clinical data of 65 patients with CTD-PAH diagnosed by right heart catheterization in the Department of Rheumatol-ogy and Immunology of the First Affiliated Hospital of Nanjing Medical University from January 2017 to December 2021.Treatment to target was determined according to the following three criteria:World Health Organization(WHO)functional class Ⅰto Ⅱ,6-minute walk distance(6MWD)＞440 m,and N-terminal pro-B-type natriuretic peptide(NT-proBNP)＜300 ng/L.The primary study endpoint was 3-year all-cause mortality,and the secondary endpoint was the first clinical worsening event within 3 years.The Kaplan-Meier method was used to calculate cumulative survival rate and event-free sur-vival rate.Results Among the 65 CTD-PAH patients,38 underwent standardized follow-up within one year after PAH diagnosis by right heart catheterization,while 27 received non-standardized fol-low-up.There were no significant differences in proportion of gender(female),age,disease types of CTD,and PAH severity between the regular follow-up group and the irregular follow-up group(P＞0.05).The 3-year survival rate of CTD-PAH patients with regular follow-up within one year of diagnosis was significantly higher than that of patients with irregular follow-up(P=0.004).Among the 38 patients with regular follow-up,one patient died,with 1-year and 3-year cumulative survival rates of 100.0％and 95.7％,respectively;among the 27 patients with irregular follow-up,8 pa-tients died,with 1-year and 3-year cumulative survival rates of 81.5％and 68.0％,respectively.Further analysis of factors influencing follow-up compliance in CTD-PAH patients revealed that age(OR=1.045,95％CI,1.006 to 1.085,P=0.023)and non-medical insurance payment(OR=5.333,95％CI,1.260 to 22.567,P=0.023)were the main factors influencing follow-up compli-ance for CTD-PAH.Among the 38 CTD-PAH patients with regular follow-up,14 achieved PAH treatment targets within one year,with no clinical failure events occurring,and 1-year and 3-year e-vent-free survival rates of 100.0％;24 patients did not achieve PAH treatment targets within one year,with 7 experiencing clinical worsening events,and 1-year and 3-year event-free survival rates of 87.5％and 69.3％,respectively.Conclusion Regular follow-up within one year of diagnosis may improve the long-term prognosis of patients with CTD-PAH.关键词
结缔组织病相关肺动脉高压/规律随访/预后影响因素/治疗达标/随访依从性/N末端B型利钠肽原/累积生存率/无事件生存率Key words
connective tissue disease-associated pulmonary arterial hypertension/regular fol-low-up/prognostic influencing factors/treat to target/follow-up compliance/N-terminal pro-B-type natriureticpeptide/cumulative survival rate/event-free survival rate分类
医药卫生引用本文复制引用
丁金,陶鸿蕊,蒋彩云,孙晓萱,张茜,周兰兰..规律随访且治疗达标对结缔组织病相关肺动脉高压患者预后的影响[J].实用临床医药杂志,2025,29(24):49-54,6.基金项目
江苏省自然科学基金青年基金项目(BK20210963) （BK20210963）
