血液透析患者并发肺动脉高压的相关因素及预后

发布时间：2019-06-15 15:04

【摘要】：目的:探讨血液透析(HD)患者并发肺动脉高压(PH)的相关因素及预后。方法:选取2014年6月之前在我院血液透析中心行HD治疗的患者90例进行前瞻性随访1年,比较并发PH(PH组)和无PH(非PH组)患者的临床资料、心脏彩超、血管钙化相关指标及预后。结果:PH组的血白蛋白水平、Kt/V显著低于非PH组,其血尿素氮和肌酐显著高于非PH组(P0.05)。两组血管钙化相关指标如冠脉钙化积分、腹主动脉和心脏瓣膜钙化、甲状旁腺激素、钙、磷、碱性磷酸酶、25羟维生素D比较差异均无统计学意义。PH组的左室收缩末期、舒张末期内径、左房内径、左室质量指数均显著大于非PH组,PH组左室射血分数显著低于非PH组(P0.05)。Logistic回归分析结果显示,左房内径的增加与HD患者并发PH显著相关(OR=2 538.116,P=0.000)。PH组的全因死亡率高于非PH组,但差异无统计学意义。PH组中急性心功能不全发生率(35.13%)显著高于非PH组。结论:HD患者并发PH者较为常见,低白蛋白血症、尿毒症毒素、心脏结构及功能异常以及容量负荷可能参与HD患者并发PH的发生。
[Abstract]:Objective: to investigate the related factors and prognosis of (PH) complicated with pulmonary hypertension in patients with (HD). Methods: 90 patients treated with HD in hemodialysis center of our hospital before June 2014 were followed up prospective for 1 year. The clinical data, cardiac color Doppler ultrasound, vascular calcification and prognosis of patients complicated with PH (PH and non-PH (non-PH group) were compared. Results: the levels of serum albumin and Kt/V in PH group were significantly lower than those in non-PH group, and the blood urea nitrogen and creatinine in PH group were significantly higher than those in non-PH group (P 0.05). There was no significant difference in vascular calcification between the two groups, such as coronary artery calcification score, calcification of abdominal aortic and cardiac valve, parathyroid hormone, calcium, phosphorus, alkaline phosphatase and 25 hydroxyvitamin D. the left ventricular end-systolic diameter, end-diastolic diameter, left atrial diameter and left ventricular mass index in PH group were significantly higher than those in non-PH group. The left ventricular ejection fraction in PH group was significantly lower than that in non-PH group (P 0.05). Logistic regression analysis showed that the increase of left atrial diameter was significantly correlated with PH in HD patients (OR=2 538.116, P 鈮，

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