【摘要】 目的 研究超声心动图测量的肺血管阻力(PVRe)对肺高血压高度可能(PHe)患者的预后价值。方法 本前瞻性观察研究纳入了常规超声心动图检查中发现的PHe住院患者，使用三尖瓣反流峰速与右心室流出道血流速度时间积分比值估测PVRe,随访全因死亡或多器官功能衰竭持续恶化放弃治疗等终点事件。结果 598例患者，年龄中位数76(IQR 69～83)岁，男315例(52.7%)。中位随访时间92(42～156)天，达到终点事件35例，其PVRe[3.2(2.4～5.1)WU]高于其他病例[2.8(2.2～3.6)WU,P=0.026]。多元Cox回归分析发现，PVRe>5 WU是无终点事件生存时间缩短的独立危险因素，以PVRe≤2 WU为参比HR=6.59(95%CI:1.73～25.06,P=0.006)。结论 PVRe>5 WU的PHe患者生存时间缩短，可优化风险分层。更多还原

【Abstract】 Objective To determine the prognostic value of pulmonary vascular resistance measured by echocardiography(PVRe) in patients with high probability of pulmonary hypertension(PHe). Methods This prospective observational study enrolled adult PHe inpatients during routine echocardiographic assessment. Echocardiographic PVR was estimated by the ratio of peak tricuspid regurgitation velocity to the velocity-time integral of the right ventricular outflow tract. Clinical and echocardiographic data were collected. The endpoint was all-cause death or withdrawing treatment for deteriorating of multiple organs failure at follow-up. Results A total of 598 patients were included, the median age was 76(IQR:69-83) years, 52.7% of whom were male. A total of 35 patients reached the endpoint at 92(42-156) days follow-up, who had higher values of PVRe [3.2(2.4-5.1) WU vs. 2.8(2.2-3.6) WU,P=0.026]. Multivariable Cox regression analysis revealed PVRe>5 WU to be independently associated with the endpoint, hazard ratio(HR)=6.59 [95% confidence interval(CI) 1.73-25.06,P=0.006], compared to the baseline of PVRe≤2 WU. Conclusions PVRe>5 WU is independently associated with adverse outcomes in patients with PHe, which can optimize risk stratification.更多还原