摘要
目的探讨双肺移植治疗重症特发性肺动脉高压（IPAH）的临床疗效。方法回顾性分析无锡市人民医院行双肺移植治疗18例重症IPAH的临床资料，并对比分析术前术后资料。结果18例IPAH肺移植术后30 d死亡率11.1%，3个月死亡率22.2%，1、3、5年的生存率分别为77.8%、72.2%、72.2%。现存13例心肺功能良好，长期生活质量佳，世界卫生组织（WHO）心功能评级由术前的Ⅲ级、Ⅳ级术后均改善到Ⅰ级。肺动脉收缩压由术前的（128.2±25.6） mmHg（1 mmHg＝0.133 kPa）降到术后（39.7±14.8） mmHg；肺动脉平均压由术前的（75.5±13.9） mmHg降到（19.6±6.4） mmHg；右心房压力由术前的（21.5±2.4） mmHg降到（5.2±4.2） mmHg，均P〈0.000 1。结论双肺移植是重症特发性肺动脉高压的有效治疗方法，长期生存率高。
Objective To study the clinical efficacy of bilateral lung transplantation treating for severe idiopathic pulmonary hypertension （IPAH）. Methods The clinical data of 18 cases of bilateral lung transplantation for severe IPAH were retrospectively analyzed. Comparative analysis of preoperative and postoperative sets of data was performed. Results The postoperative 30-day mortality of 18 cases was 11. 1% , 3 months mortality 22. 2%. The survival rate of 1 year, 3 years, 5 years was 77. 8%, 72. 2% and 72. 2%, respectively. The remaining 13 cases were able to survive for a long time which preoperative cardiac function rating of level Ⅲ, Ⅳ were improved to level I after transplantation. Compared preoperative with postoperative, pulmonary artery systolic pressure from preoperative 128.2 ± 25.6 mmHg dropped to postoperative 39. 7 ±14. 8 mmHg; pulmonary artery mean pressure from 75.5 ±13.94 mmHg to 19. 61±6.43 mmHg; right atrial pressure from 21.5±2.43 mmHg to 5.22±4. 18 mmHg, all P 〈 0. 000 1. Conclusion Bilateral lung transplantation is an effective treatment for severe idiopathic pulmonary arterial hypertension, which has longer survival.
出处
《中华医学杂志》
CAS
CSCD
北大核心
2016年第36期2909-2911,共3页
National Medical Journal of China
关键词
肺移植
特发性肺动脉高压
Lung transplantation
Idiopathic pulmonary hypertension （Familial Primary Pulmonary Hypertension, IPAH）
