腹膜透析患者肺淤血危险因素分析及肺超声对其容量状态的评估价值

发布时间：2017-12-31 15:10

本文关键词：腹膜透析患者肺淤血危险因素分析及肺超声对其容量状态的评估价值　出处：《广东医学》2017年06期 　论文类型：期刊论文

【摘要】：目的调查肺淤血在腹膜透析(腹透)患者的发生率及分析其发病的危险因素,探讨肺超声在腹透患者容量评估中的应用价值。方法将98例腹透患者按B线数目分两组,无或轻度肺淤血组(B线≤15)和中重度肺淤血组(B线15),比较两组间临床指标的差异,二分类logistic回归分析影响肺淤血发生的危险因素。X~2检验比较以肺超声及下肢水肿评估容量的一致性。Spearman相关分析B线数目和血B型尿钠肽水平的相关性。结果肺淤血发生率52.0%,中重度者达37.8%。与无或轻度肺淤血组相比,中重度肺淤血组糖尿病、肺动脉高压和NYHAⅢ~Ⅳ级者较多,而血白蛋白、钙磷乘积较低(P均0.01)。多因素分析显示糖尿病、低白蛋白血症及肺动脉高压是肺淤血发生的独立危险因素(P均0.05)。下肢水肿者83.3%存在肺淤血,而肺淤血者仅39.2%存在下肢水肿(Kappa0.4,P0.01)。B线数目和血B型尿钠肽水平显著相关(r=0.692,P0.01)。结论腹透患者肺淤血发生率高。肺淤血的发生与糖尿病、低白蛋白血症及肺动脉高压有关。下肢水肿预测肺淤血准确度低。肺超声或有助指导容量超负荷的早期诊断与干预。
[Abstract]:Objective to investigate the pulmonary congestion in peritoneal dialysis (PD) risk factors and the incidence rate of the patients, to explore the application value of ultrasound in the assessment of lung capacity in peritoneal dialysis patients. Methods 98 cases of peritoneal dialysis patients were divided into two groups according to B line number, no or mild pulmonary congestion group (B < 15) and severe pulmonary congestion group (B 15), the difference between the two groups of clinical indicators, two logistic classification.X~2 regression analysis of risk factors of pulmonary congestion occurred in comparison to test the impact of correlation between ultrasound and pulmonary edema of lower extremity assessment capacity of the consistency of.Spearman correlation analysis B line number and B blood type natriuretic peptide levels. Results pulmonary congestion the incidence rate of 52%, in severe 37.8%. with no or mild pulmonary congestion group, severe pulmonary congestion group diabetes, more pulmonary hypertension and NYHA grade, and serum albumin, calcium and phosphorus product is low (P < 0.01). Multivariate analysis showed that diabetes, low Serum albumin levels and pulmonary hypertension are independent risk factors for pulmonary congestion occurred (P 0.05). There were 83.3% lower extremity edema pulmonary congestion, pulmonary congestion and edema of lower extremity is only 39.2% (Kappa0.4, P0.01) were significantly related to.B line number and B blood type natriuretic peptide levels (r=0.692, P0.01). Conclusion in peritoneal dialysis patients the high incidence of pulmonary congestion and pulmonary congestion. Diabetes, hypoalbuminemia and pulmonary hypertension. Lower extremity edema prediction accuracy is low. Pulmonary congestion of lung ultrasound or early diagnosis and intervention can guide overload capacity.

【作者单位】：汕头市中心医院肾内科;汕头市中心医院超声科;汕头市中心医院内分泌科;
【基金】：广东省医学科研基金立项项目(编号:B2016115)
【分类号】：R692.5
【正文快照】： 容量超负荷是维持性透析患者血压控制不良、左心室肥厚、肺淤血和心脑血管事件高发的重要危险因素[1-3]。根据症状体征、胸片、B型尿钠肽(B-type natriuretic peptide,BNP)与N-端B型尿钠肽前体、下腔静脉直径等判断该人群的容量状况准确度低[4-8]。目前迫切需要能在常规临床实

【相似文献】