血液透析患者肺动脉高压的临床相关因素分析

发布时间：2018-02-01 07:51

  本文关键词： 血液透析 肺动脉高压 超声心动图 NT-proBNP PTH　出处：《山西医科大学》2014年硕士论文　论文类型：学位论文

【摘要】：目的：探讨血液透析患者肺动脉高压(pulmonary hypertension, PH)发生情况,以及影响疾病发生发展的相关因素,总结其临床特点,以利于早期诊断肺动脉高压及并给予临床干预。 方法：收集2013年1月至2014年1月就诊于我院的60例资料完整的血液透析治疗患者资料,通过超声心动图检查测算肺动脉收缩压(systolic pulmonary artery pressure, PASP),根据PASP值分为两组,PASP35mmHg(1mmHg=0.133kPa)为肺动脉高压(PH)组,PASP≤35mmHg为非PH组,观察临床指标、实验室指标和心脏其他结构及功能方面指标等相关检查,采用多种统计学分析方法,比较两组之间是否存在统计学差异,并对相关因素进行Logistic回归分析。 结果：60例患者中PASP升高的占22例,发生率为36.67%(22/60)。PH组与非PH组比较,血浆甲状旁腺素(parathyroid hormone, PTH)[(275.40±133.06) pg/ml vs(177.46±133.86)pg/ml]、N末端前钠尿肽(N-terminal pro-brain natriuretic peptide, NT-proBNP)[(11122.77±6690.50) ug/L vs (6339.44±5529.50) ug/L],差异有统计学意义(P0.05)。PH组肺动脉根部径[(28.48±4.81) mm vs (24.97±3.04)mm]、左室舒张末内径[(58.82±5.05) mm vs (51.95±6.00) mm]、左房前后径[(43.55±5.82) mm vs (36.84±6.23) mm]、右室前后径[(23.86±4.24)mm vs(21.37±2.45)mm]高于非PH组,左室射血分数PH组[(55.68±13.03)%vs(62.29±10.13)%]低于非PH组,差异有统计学意义(P0.01或P0.05)。 Logistic回归分析显示,左心室舒张末内径和左房前后径与血液透析患者并发PH情况显著相关。 结论：1.PH是血液透析患者常见的严重并发症之一；2.继发性甲状旁腺功能亢进以及一些引起心力衰竭的因素可能参与了血液透析患者并发PH的发生发展过程；3.左心疾病与PH发病情况存在相关关系；4.血液透析合并PH患者病情重且复杂,临床上需根据每个患者个体的整体状况来做出评估。
[Abstract]:Objective: to investigate the incidence of pulmonary hypertension (PH1) in hemodialysis patients and the related factors affecting the development of the disease. The clinical features were summarized to facilitate the early diagnosis and clinical intervention of pulmonary hypertension. Methods: 60 patients with hemodialysis were collected from January 2013 to January 2014 in our hospital. Systolic pulmonary artery pressure (PASP) was measured by echocardiography. According to the PASP value, two groups were divided into two groups: PASP35mm HgG 1 mm HgG 0.133 KPA) group (PASP35 mmHg 鈮，

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