论文部分内容阅读
目的探讨风湿性疾病继发肺动脉高压的影像学诊断及临床处理。方法对30例本病住院患者的临床资料作回顾性研究。其中继发于系统性红斑狼疮17例,混合性结缔组织病8例,系统性硬化症5例。结果患者的主要症状为胸闷、气急干咳,心脏心脏彩超(UCG)均显示右室扩张伴三尖瓣返流。3年中死亡11例(36.8%)。重度肺动脉高压患者(肺动脉收缩压大于60mmHg)20例,死亡7例。早期诊断肺动脉高压6例,无1例死亡。静脉应用环磷酰胺(CTX)冲击治疗患者的死亡率显著低于非用药组。26例患者短期应用前列地尔2周后,肺动脉收缩压平均降幅7.2%。结论风湿性疾病继发肺动脉高压预后不良。UCG有助于早期发现肺动脉高压,CTX冲击治疗对改善预后有积极作用。早期诊断和治疗是降低死亡率的关键。
Objective To investigate the imaging diagnosis and clinical treatment of pulmonary hypertension secondary to rheumatic diseases. Methods A retrospective study was conducted on the clinical data of 30 inpatients with this disease. Which occurred in 17 cases of systemic lupus erythematosus, mixed connective tissue disease in 8 cases, 5 cases of systemic sclerosis. Results The main symptoms of the patients were chest tightness, dry cough, and cardiac ultrasonography (UCG) showed right ventricular dilatation and tricuspid regurgitation. Eleven patients died in three years (36.8%). 20 patients with severe pulmonary hypertension (pulmonary systolic blood pressure greater than 60mmHg), 7 died. Early diagnosis of pulmonary hypertension in 6 cases, no one died. Mortality in patients treated with intravenous cyclophosphamide (CTX) was significantly lower than in non-medication groups. After 26 weeks of short-term application of alprostadil, pulmonary systolic pressure decreased by an average of 7.2%. Conclusions The prognosis of pulmonary hypertension secondary to rheumatic diseases is poor. UCG helps early detection of pulmonary hypertension, and CTX shock therapy has a positive effect on prognosis. Early diagnosis and treatment are the key to reducing mortality.