Page 48 - 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4期
·498 · Journal of Nanjing Medical University（Natural Sciences） 2022年4月

·临床研究·

静息心率预测结缔组织疾病相关肺动脉高压患者远期预后的

价值

武倩文，孙晓萱，叶黄戍，王 嫱 *
南京医科大学第一附属医院风湿免疫科，江苏 南京 210029

［摘 要］ 目的：探索静息状态下测得心率对结缔组织疾病相关肺动脉高压（connective tissue disease⁃associated pulmonary
arterial hypertension，CTD⁃PAH）患者远期预后的预测作用。方法：收集2009—2021年南京医科大学第一附属医院风湿免疫科
收治的所有经右心导管确诊的CTD⁃PAH患者89 例。比较心率 < 100 次/min和心率≥100 次/min患者的临床特点、二维超声心
动图参数、血流动力学参数及生存情况。采用Kaplan⁃Meier、Cox方法进行生存分析。结果：两组患者性别、年龄、WHO 心功能
分级、6 min 步行距离、末端脑钠肽前体、二维超声心动图及血流动力学参数的差异均无统计学意义（P > 0.05）。与静息心
率 < 100 次/min 的 CTD⁃PAH 患者相比，静息心率≥100 次/min 的患者病死率更高（P < 0.01）。静息心率 < 100 次/min 和
≥100 次/min的患者1年、3年及5年的总体生存率分别为98.6%、90.7%、87.6%和93.8%、66.8%、55.6%。校正年龄和性别后静
息心率≥100 次/min仍是CTD⁃PAH 预后的独立危险因素。结论：静息心率可能是预测CTD⁃PAH 患者远期不良预后的指标之
一，可反映右心室整体功能情况。
［关键词］ 结缔组织病相关肺动脉高压；静息心率；右心功能；预后
［中图分类号］ R593.2 ［文献标志码］ A ［文章编号］ 1007⁃4368（2022）04⁃498⁃05
doi：10.7655/NYDXBNS20220406

Value of resting heart rate in predicting long ⁃ term prognosis in patients with connective
tissue disease⁃associated pulmonary arterial hypertension
WU Qianwen，SUN Xiaoxuan，YE Huangshu，WANG Qiang *
Department of Rheumatology，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029，China

［Abstract］ Objective：To explore the relationship between resting heart rate and long⁃term prognosis of patients with connective
tissue disease⁃associated pulmonary arterial hypertension（CTD⁃PAH）. Methods：A total of 89 patients with CTD⁃PAH diagnosed by
right cardiac catheterization were collected from the Departments of Rheumatology，the First Affiliated Hospital of Nanjing Medical
University from 2009 to 2021. The clinical characteristics，two⁃dimensional echocardiographic parameters，hemodynamic parameters
and survival of patients with heart rate < 100 beats/min and heart rate ≥100 beats/min were compared. Kaplan⁃Meier and Cox methods
were used for survival analysis. Results：There was no significant difference in sex，age，WHO functional class，6⁃minute walking
distance，N⁃terminal pro⁃brain natriuretic peptide，two⁃dimensional echocardiographic and hemodynamic parameters between the two
groups. The mortality of patients with resting heart rate ≥100 beats/min was higher than that of patients with resting heart rate <100
beats/min（P < 0.01）. The overall 1⁃，3⁃ and 5⁃year survival rates of patients with resting heart rate < 100 beats/min and ≥ 100 beats/
min were 98.6%，90.7%，87.6% and 93.8%，66.8%，55.6%. After adjustment for age and sex，resting heart rate ≥100 beats/min
remained an independent risk factor for prognosis of patients with CTD⁃PAH. Conclusion：The resting heart rate may be one of the
indexes to predict the long⁃term poor prognosis of patients with CTD⁃PAH and may reflect the overall function of the right ventricle.
［Key words］ connective tissue disease associated with pulmonary arterial hypertension；resting heart rate；right heart function；
prognosis
［J Nanjing Med Univ，2022，42（04）：498⁃502］

［基金项目］ 国家自然科学基金（81701610, 82071827）
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通信作者（Corresponding author），E⁃mail：jerrytortoise@163.com