Prognosis of patients with chronic thromboembolic pulmonary hypertension receiving conservative or operative treatments according to a new clinical classiftcation scheme
10.3321/j.issn:0253-3758.2008.01.004
- VernacularTitle:慢性栓塞性肺动脉高压手术与非手术治疗的转归及其临床分型的探讨
- Author:
Hui-Li GAN
1
;
Jian-Qun ZHANG
;
Zhao-Guang ZHANG
;
Yi LUO
;
Jun-Sheng MU
;
Qi-Wen ZHOU
;
Sheng-Xun WANG
;
Si-Hong ZHENG
;
Guang-Fa ZHU
;
Xiang-Feng ZHANG
;
Shuang LIU
Author Information
1. 首都医科大学附属北京安贞医院
- Keywords:
Pulmonaty embolism;
Pulmonary Artery;
Endarteretomy(PTE)
- From:
Chinese Journal of Cardiology
2008;36(1):11-15
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the efficacy of conservative or pulmonary thromboendarterectomy (PTE) therapy for chronic thromboembolic pulmonary hypertension (CTEPH) patients according to a new clinical classification scheme.Methods This retrospective study analyzed 63 cases of CTEPH admitted to our hospital from February 1995 to October 2007 and 45 cases were treated surgically (Group A) and 18 cases received conservative therapy(Group B).Results were analyzed using Fisher exact test and t test according to San Diego medical center quartering classification scheme and Anzhen Hospital modified bifurcate classification scheme.Resuits There were 6 operational deaths in Group A and 2 deaths during hospital stay in Group B.During follow-ups(mean 3.6±2.5 years),there were 4 deaths in Group A and 9 deaths in Group B.the totality survival rate is significantly higher in Group A than that in Group B(P＜O.05).For patients with San Diego Type Ⅰ CTEPH,survival rate was significantly higher in Group A compared with Group B(P=0.009)and was similar for patients with type Ⅱ and Ⅲ and Ⅳ CTEPH between the two groups(P=0.338,0.455,0.800).Survival rate was significantly higher in Group A than that in Group B for patients with Anzhen central type CTEPH(P=0.009),but was similar between the two groups for patients with Anzhen peripheral type CTEPH(P:0.125).The Kaplan-Meier survival curve 5 years survival rate in the Group A was(91.7±8.0)% for Anzhen central type and (76.0±8.5)% for Anzhen peripheral type(P=0.04),and the 5 years Kaplan-Meier survival rate in the Group B was(42.9±18.7)% for Anzhen cetntral type and (56.2±10.8)% for Anzhen peripheral type (P-0.851).Conclusion Anzhen Hospital modiried bifurcate classfication scheme is a simple and effctive classification to predict the prosnosis and choose treatment method of CTEPH.
