评价经导管球囊房间隔造口术对比充分药物治疗重症肺动脉高压患者的疗效与安全性:一项前瞻性、多中心、随机对照研究

注册号:

Registration number:

ChiCTR2500113114 

最近更新日期:

Date of Last Refreshed on:

2025-11-25 09:48:45 

注册时间:

Date of Registration:

2025-11-25 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

评价经导管球囊房间隔造口术对比充分药物治疗重症肺动脉高压患者的疗效与安全性:一项前瞻性、多中心、随机对照研究

Public title:

Efficacy and Safety of Balloon Atrial Septostomy Versus Optimized Guideline-based Medical Therapy in Patients With Severe Pulmonary Arterial Hypertension: A Multicenter, Open-Label, Randomized Controlled Trial (BRIDGE Study)

注册题目简写:

BRIDGE

English Acronym:

研究课题的正式科学名称:

肺动脉高压危象介入救治与机械支持挽救性治疗策略——评价经导管球囊房间隔造口术对比充分药物治疗重症肺动脉高压患者的疗效与安全性:一项前瞻性、 多中心、随机对照研究

Scientific title:

Efficacy and Safety of Balloon Atrial Septostomy Versus Optimized Guideline-based Medical Therapy in Patients With Severe Pulmonary Arterial Hypertension: A Multicenter, Open-Label, Randomized Controlled Trial (BRIDGE Study)

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

蒋鑫 

研究负责人:

荆志成 

Applicant:

Jiang Xin 

Study leader:

Zhicheng Jing 

申请注册联系人电话:

Applicant telephone:

+86 159 1064 6886

研究负责人电话:

Study leader's
telephone:

+86 135 0135 3191

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

jxcs983@163.com

研究负责人电子邮件:

Study leader's E-mail:

jingzhicheng@vip.163.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

广州市越秀区中山二路106号

研究负责人通讯地址:

广州市越秀区中山二路106号

Applicant address:

No.106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, China

Study leader's address:

No.106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

广东省人民医院

Applicant's institution:

Guangdong Provincial People's Hospital

研究负责人所在单位:

广东省人民医院

Affiliation of the Leader:

Guangdong Provincial People's Hospital

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

KY2025-841-03; KY2025-841-04

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

广东省人民医院伦理审查委员会

Name of the ethic committee:

Ethics Review Committee of Guangdong Provincial People's Hospital

伦理委员会批准日期:

Date of approved by ethic committee:

2025-11-05 00:00:00

伦理委员会联系人:

姚丽明

Contact Name of the ethic committee:

Liming Yao

伦理委员会联系地址:

广州市越秀区中山二路106号

Contact Address of the ethic committee:

No.106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 20 8352 5173

伦理委员会联系人邮箱:

Contact email of the ethic committee:

gdghospital_ec@gdph.org.cn

研究实施负责(组长)单位:

广东省人民医院

Primary sponsor:

Guangdong Provincial People's Hospital

研究实施负责(组长)单位地址:

广州市越秀区中山二路106号

Primary sponsor's address:

No.106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

广东省

市(区县):

Country:

China

Province:

Guangdong

City:

单位(医院):

广东省人民医院

具体地址:

广州市越秀区中山二路106号

Institution
hospital:

Guangdong Provincial People's Hospital

Address:

No.106 Zhongshan 2nd Road, Yuexiu District, Guangzhou, China

经费或物资来源:

癌症、心脑血管、呼吸和代谢性疾病防治研究国家科技重大专项

Source(s) of funding:

Noncommunicable Chronic Diseases-National Science and Technology Major Project (2024ZD0526700)

研究疾病:

肺动脉高压  

Target disease:

Pulmonary Arterial Hypertension

研究疾病代码:

I27.21

Target disease code:

I27.21

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

治疗新技术临床试验 

Study phase:

New Treatment Measure Clinical Study

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

本研究旨在评价经导管球囊房间隔造口术(Balloon Atrial Septostomy, BAS)在终末期肺动脉高压及肺动脉高压危象患者中的生存及预后改善效果。本研究为多中心、前瞻性、随机对照试验,重点评估BAS对患者24个月无肺移植生存率的影响,同时观察其对血流动力学、右心结构与功能重构、临床症状及运动耐量的改善,以及对术后1年和3年全因死亡率的影响。本研究亦将系统评估BAS的围手术期及远期安全性。  

Objectives of Study:

This study aims to evaluate the survival and prognostic benefits of balloon atrial septostomy (BAS) in patients with end-stage pulmonary arterial hypertension or PAH crisis. In this multicenter, prospective, randomized controlled trial, the primary focus is to assess transplant-free survival at 24 months. Additionally, the study will examine improvements in hemodynamics, right ventricular structure and function, clinical symptoms, and exercise capacity, as well as impacts on 1-year and 3-year all-cause mortality. The peri-procedural and long-term safety profile of BAS will also be systematically evaluated.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1.有严重基础肺部疾病影响患者血氧饱和度; 2.吸氧状态下仍无法平卧患者; 3.有严重凝血功能障碍或对比剂过敏无法耐受心脏介入手术; 4.术前合并感染尚未纠正患者; 5.急慢性器质性疾病或精神疾病导致患者不能配合; 6.有恶性肿瘤等严重合并症,预期生存时间少于1 年 7.不能配合研究或拒绝签署知情同意书。 8.具有任何可能影响方案依从性的疾病史(如严重精神障碍、认知功能障碍、药物滥用或成瘾等); 9.研究者判断不宜参加本研究的患者。

Exclusion criteria:

1. Severe underlying pulmonary disease affecting oxygen saturation. 2. Inability to lie flat even with supplemental oxygen. 3. Severe coagulation disorders or contrast agent allergy preventing cardiac interventional procedures. 4. Active, uncontrolled infection prior to intervention. 5. Acute or chronic organic or psychiatric conditions preventing patient cooperation. 6. Malignancy or other severe comorbidities with an expected survival of less than 1 year. 7. Inability or refusal to comply with study requirements or to provide informed consent. 8. History of conditions that may affect protocol adherence, such as severe mental disorders, cognitive impairment, or substance abuse/addiction. 9. Any other condition deemed by the investigator to make participation inappropriate.

研究实施时间:

Study execute time:

From 2025-02-01 00:00:00 To 2029-01-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2025-11-30 00:00:00 To 2028-08-31 00:00:00

干预措施:

Interventions:

组别:

手术组

样本量:

102

Group:

Surgery group

Sample size:

干预措施:

试验组受试者将接受经导管球囊房间隔造口术,并根据研究者判断,继续接受药物治疗

干预措施代码:

Intervention:

Participants in the experimental arm will receive percutaneous balloon atrial septostomy, performed by experienced interventional cardiologists following standard procedural protocols. After the procedure, participants may continue optimized PAH-targeted medical therapy as determined by the investigator.

Intervention code:

组别:

对照组

样本量:

102

Group:

Control group

Sample size:

干预措施:

对照组参与者将接受指南推荐的肺动脉高压药物治疗,包括三联或更多靶向肺动脉高压疗法(如内皮素受体拮抗剂、磷酸二酯酶5型抑制剂、前列环素类似物)。入组后,参与者将接受右心导管检查作为研究评估的一部分。

干预措施代码:

Intervention:

In control group, participants will receive guideline-directed optimized pharmacologic therapy for severe pulmonary arterial hypertension, including triple or more targeted PAH therapies (e.g., endothelin receptor antagonists, phosphodiesterase type 5 inhibitors, prostacyclin analogues). After enrollment, participants will undergo right heart catheterization as part of the study assessments.

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

广东省人民医院 

单位级别:

三甲 

Institution
hospital:

Guangdong Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

北京大学第一医院 

单位级别:

三甲 

Institution
hospital:

Peking University First Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

广东 

市(区县):

 

Country:

China

Province:

Guangdong

City:

单位(医院):

广州医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Guangzhou Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

黑龙江 

市(区县):

 

Country:

China

Province:

Heilongjiang

City:

单位(医院):

哈尔滨医科大学附属第二医院 

单位级别:

三甲 

Institution
hospital:

The Second Affiliated Hospital of Harbin Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

吉林 

市(区县):

 

Country:

China

Province:

Jilin

City:

单位(医院):

吉林大学白求恩第一医院 

单位级别:

三甲 

Institution
hospital:

The First Bethune Hospital of Jilin University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

北京 

市(区县):

 

Country:

China

Province:

Beijing

City:

单位(医院):

首都医科大学附属宣武医院 

单位级别:

三甲 

Institution
hospital:

Xuanwu Hospital of Capital Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

天津 

市(区县):

 

Country:

China

Province:

Tianjin

City:

单位(医院):

天津医科大学总医院 

单位级别:

三甲 

Institution
hospital:

Tianjin Medical University General Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

重庆 

市(区县):

 

Country:

China

Province:

Chongqing

City:

单位(医院):

重庆医科大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Chongqing Medical University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

复旦大学中山医院 

单位级别:

三甲 

Institution
hospital:

Zhongshan Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

上海交通大学医学院附属胸科医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Chest Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

同济大学附属上海市肺科医院 

单位级别:

三甲 

Institution
hospital:

Shanghai Pulmonary Hospital Affiliated To Tongji University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

 

Country:

China

Province:

Shanghai

City:

单位(医院):

同济大学附属同济医院 

单位级别:

三甲 

Institution
hospital:

Tongji Hospital Affiliated To Tongji University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

陕西 

市(区县):

 

Country:

China

Province:

Shaanxi

City:

单位(医院):

西安交通大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Xi’an Jiaotong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

山东 

市(区县):

 

Country:

China

Province:

Shandong

City:

单位(医院):

山东大学齐鲁医院 

单位级别:

三甲 

Institution
hospital:

Qilu Hospital of Shandong University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

江苏省人民医院 

单位级别:

三甲 

Institution
hospital:

Jiangsu Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

江苏 

市(区县):

 

Country:

China

Province:

Jiangsu

City:

单位(医院):

徐州市中心医院 

单位级别:

三甲 

Institution
hospital:

XuZhou Central Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

甘肃 

市(区县):

 

Country:

China

Province:

Gansu

City:

单位(医院):

甘肃省人民医院 

单位级别:

三甲 

Institution
hospital:

Gansu Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

甘肃 

市(区县):

 

Country:

China

Province:

Gansu

City:

单位(医院):

兰州大学第一医院 

单位级别:

三甲 

Institution
hospital:

The First Hospital of Lanzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

四川 

市(区县):

 

Country:

China

Province:

Sichuan

City:

单位(医院):

四川省人民医院 

单位级别:

三甲 

Institution
hospital:

Sichuan Provincial People's Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

云南 

市(区县):

 

Country:

China

Province:

Yunnan

City:

单位(医院):

昆明市延安医院 

单位级别:

三甲 

Institution
hospital:

Kunming Yanan Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

福建 

市(区县):

 

Country:

China

Province:

Fujian

City:

单位(医院):

厦门市中医院 

单位级别:

三甲 

Institution
hospital:

Xiamen Hospital of Traditional Chinese Medicine

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

武汉大学中南医院 

单位级别:

三甲 

Institution
hospital:

Zhongnan Hospital of Wuhan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

武汉亚洲心脏病医院 

单位级别:

三甲 

Institution
hospital:

Wuhan Asia Heart Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖北 

市(区县):

 

Country:

China

Province:

Hubei

City:

单位(医院):

江汉大学附属医院 

单位级别:

三甲 

Institution
hospital:

Jianghan University Affiliated Hospital

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅医院 

单位级别:

三甲 

Institution
hospital:

Xiangya Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

湖南 

市(区县):

 

Country:

China

Province:

Hunan

City:

单位(医院):

中南大学湘雅二医院 

单位级别:

三甲 

Institution
hospital:

The Second Xiangya Hospital of Central South University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河南 

市(区县):

 

Country:

China

Province:

Henan

City:

单位(医院):

阜外华中心血管病医院 

单位级别:

三甲 

Institution
hospital:

Fuwai Central China Cardiovascular Hospital

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

术后24个月无肺移植生存率

指标类型:

主要指标

Outcome:

24-month transplant-free survival (post-procedure)

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

3年全因死亡率

指标类型:

次要指标

Outcome:

3-year all-cause mortality

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

3年无临床恶化事件生存率

指标类型:

次要指标

Outcome:

3-year event-free survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

6月 LVEDD/RVEDD变化

指标类型:

次要指标

Outcome:

6-month LVEDD/RVEDD changes

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

1年全因死亡率

指标类型:

次要指标

Outcome:

1-year all-cause mortality

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

1年无临床恶化事件生存率

指标类型:

次要指标

Outcome:

1-year event-free survival

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

BAS围术期并发症发生率

指标类型:

次要指标

Outcome:

perioperative BAS complications

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

BAS术后30天死亡率

指标类型:

次要指标

Outcome:

30-day post-BAS mortality

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

肺高血压相关再住院率

指标类型:

次要指标

Outcome:

Pulmonary hypertension-related rehospitalization rate

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

NA

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

正在进行

Recruiting

年龄范围:

Participant age:

最小 Min age 18 years
最大 Max age 70 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

随机序列由项目独立非盲统计人员,遵照研究方案,使用SAS统计软件,采用区组随机化 方法生成。生成的随机化表包含编号、治疗分组及区组信息。

Randomization Procedure (please state who generates the random number sequence and by what method):

The random sequence was generated by an independent, unblinded statistician using SAS statistical software and the block randomization method, in accordance with the study protocol. The resulting randomization list contained the subject number, treatment assignment, and block information.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

公开/Public

盲法:

本试验为开放标签设计,未对受试者、干预实施者(操作医师)或结局评估者设置盲法。这是由于试验组(经导管球囊房间隔造口术)与对照组(充分联合靶向药物治疗)的干预措施性质差异巨大,在技术上无法对参与者或操作医师设盲。

Blinding:

This trial was an open-label study. No blinding was applied to the subjects, intervention providers (operating physicians), or outcome assessors. This was because the nature of the interventions differed fundamentally between the trial group (transcatheter balloon atrial septostomy) and the control group (full combined targeted drug therapy), making it technically impossible to blind the participants or the operating physicians.

试验完成后的统计结果(上传文件):

Calculated Results after
the Study Completed(upload file):

是否共享原始数据:

IPD sharing

否No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

本研究不共享原始个体数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

No IPD sharing

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

各项指标按预定时间点采集,所有检测数据均需记录在标准化病例报告表(CRF)上,并由独立、盲态评估人员进行结果审核。并使用电子数据采集与管理系统(EDC)进行数据录入、管理与质量控制。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

All study endpoints will be collected at predefined time points and documented in standardized Case Report Forms (CRFs), with outcome assessments reviewed by independent, blinded evaluators. Data entry, management, and quality control will be conducted using an Electronic Data Capture (EDC) system.

数据与安全监察委员会:

Data and Safety Monitoring Committee:

暂未确定/Not yet

注册人:

Name of Registration:

 2025-11-25 09:48:14