Butrous 2 China August 2009s 英文 医学资料.ppt

* PVRI Schistosomiasis Taskforce Comparison of PE Brazil and France PHT database French data from Humbert M; Am J Resp Crit Care 2006, 173 Brazil data from Angela Bandera % 0 5 10 15 20 25 30 35 40 45 50 Schisto Idiopathic Cong HD conn. TD Others Pernambuco 1 center 281 Pts France 17 Centers 674 Pts * What are the issues with schistosomiasis PHT? The real prevalence and severity of the condition The clinical profile, pattern and natural history of the pulmonary hypertension The pathophysiology? The treatment of pulmonary hypertension secondary to schistosomiasis? * HIV Pulmonary Hypertension * HIV associated pulmonary hypertension The prevalence is 0.5% In Africa suggested that the prevalence may range from 0.6% to 5%, with higher numbers in the hospitalized as opposed to ambulant patients The incidence however has not been affected by the introduction of the HAART treatment Deaths due to right heart failure, cardiogenic shock and sudden death… not due to HIV infection Many regions in the world have both HIV and co-infection (Kallestrup et al J Infect Dis. 2005) Mwanakasale Am J Trop Med Hyg 2003) * Sitbon O, et al. Am J Respir Crit Care Med 2008; 177:108-13 * Opravil, Am J Respir Crit Care Med 1997 N=38 Median 2.6 years Median 1.3 years Survival of HIV+ pts with and without PH * Cool et al H&E Factor VIII Complex pulmonary vascular lesions in HIV-infected patients with PH * HIV associated pulmonary hypertension The histopathological features of HIV associated pulmonary hypertension have some similarities to the idiopathic pulmonary arterial hypertension 78% Plexiform Lesion HIV does not appear to infect endothelial cells directly Edwards WA lab Mayo clinic) * Map illustrating the current and former areas of endemic schistosomiasis (shaded) in China. The disease has now been eradicated from three important zones: the whole Pearl River system (Guangxi and Guangdong), the isolated coastal focus (Fujian), and the Yangtze delta (Shanghai, Zhejang