Page 68 - 南京医科大学学报自然科学版

南京医科大学学报（自然科学版） 第42卷第11期
·1560 · Journal of Nanjing Medical University（Natural Sciences） 2022年11月

·临床研究·

食管扩张预测结缔组织疾病相关肺动脉高压患者远期预后的

价值

杜梦迪 ，张春芳 ，顾 镭 ，叶黄戍 ，祝因苏 ，王 嫱 ，孙晓萱 1*
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南京医科大学第一附属医院风湿免疫科，放射科，江苏 南京 210029
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［摘 要］ 目的：探索食管扩张对结缔组织疾病相关肺动脉高压（connective tissue disease⁃associated pulmonary arterial hyper⁃
tension，CTD⁃PAH）患者远期预后的预测作用。方法：收集2010年5月—2022年4月南京医科大学第一附属医院风湿免疫科收
治的所有经二维超声心动图诊断的CTD⁃PAH患者170例。以主动脉弓下食管直径>9 mm定义为食管扩张，比较无食管扩张和
食管扩张CTD⁃PAH患者的临床特征、二维超声心动图参数、胸部CT参数及生存情况。采用Kaplan⁃Meier、Cox方法进行生存分
析。结果：伴有食管扩张的CTD⁃PAH患者年龄更大，N末端B型利钠肽前体（N⁃terminal B⁃type natriuretic peptide precursor，NT⁃
proBNP）数值更高，5年全因死亡率显著升高。两组患者性别、WHO心功能分级、肺动脉收缩压及胸部CT参数的差异均无统
计学意义。无食管扩张的CTD⁃PAH患者1年、3年及5年总体生存率分别为100.0%、95.2%、84.8%，伴食管扩张的CTD⁃PAH患
者1年、3年及5年总体生存率分别为93.6%，73.0%、62.3%。校正年龄、性别、PAH病程、NT⁃proBNP水平后食管扩张仍是CTD⁃
PAH预后的独立危险因素。结论：食管扩张可能是预测CTD⁃PAH患者远期不良预后的指标之一。
［关键词］ 结缔组织病相关肺动脉高压；食管扩张；预后
［中图分类号］ R593.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）11⁃1560⁃06
doi：10.7655/NYDXBNS20221109

The prognostic value of esophageal dilatation in connective tissue disease with
pulmonary arterial hypertension
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DU Mengdi ，ZHANG Chunfang ，GU Lei ，YE Huangshu ，ZHU Yinsu ，WANG Qiang ，SUN Xiaoxuan 1*
1 Department of Rheumatology，Department of Radiology，the First Affiliated Hospital of Nanjing Medical University，
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Nanjing 210029，China
［Abstract］ Objective：This study aims to explore the prognostic value of esophageal dilatation in connective tissue disease with
pulmonary arterial hypertension（CTD⁃PAH）. Methods：A total of 170 patients with CTD⁃PAH diagnosed by echocardiography were
collected from the Departments of Rheumatology，the First Affiliated Hospital of Nanjing Medical University from 2010 to 2022.
Clinical characteristics，echocardiographic parameters，chest CT parameters and survival of patients with esophageal dilatation and
without esophageal dilatation were compared. Kaplan⁃Meier and Cox methods were used for survival analysis. Esophageal dilatation is
defined by coronal diameter of the esophagus lumen >9 mm at the infra⁃aortic portion of the esophagus. Results：The mortality of
patients with esophageal dilatation was higher than that of patients without esophageal dilatation. The overall 1⁃，3⁃ and 5⁃year survival
rates of patients without esophageal dilatation were 100.0%，95.2%，84.8%，while the overall 1⁃，3⁃ and 5⁃year survival rates of patients
with esophageal dilatation were 93.6% ，73.0% ，62.3% . After adjustment for age，sex，PAH duration，and N ⁃ terminal pro ⁃ B type
natriuretic peptide（NT⁃proBNP），esophageal dilatation remained an independent risk factor for prognosis of patients with CTD⁃PAH.
Conclusion：Esophageal dilatation may be one of the indexes to predict the long⁃term poor prognosis of patients with CTD⁃PAH.
［Key words］ connective tissue disease associated with pulmonary arterial hypertension；esophageal dilatation；prognosis
［J Nanjing Med Univ，2022，42（11）：1560⁃1564，1571］

［基金项目］ 国家自然科学基金（81701610，82071827）；江苏省人民医院临床能力提升工程（JSPH⁃MC⁃2021⁃9）
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通信作者（Corresponding author），E⁃mail：drsunxiaoxuan@163.com