终末期肾病病人伴发肺动脉高压的临床研究

目的:回顾性分析进行血液透析的终末期肾病(ESRD)病人肺动脉压力(PAP)情况,探讨ESRD病人肺动脉高压(PAH)的发生情况及可能的影响因素.方法:选择128例ESRD病人,其中进行血液透析的66例病人作为观察组,无血液透析的62例病人作为对照组,应用超声心动图对病人的PAP进行评估,比较2组病人一般资料、超声心动...

Clinical study of pulmonary artery hypertension in patients with end-stage renal disease

ObjectiveTo analyze the pulmonary artery pressure(PAP)of 128 end-stage renal disease(ESRD)patients treated with hemodialysis, investigate the occurrence of pulmonary artery hypertension(PAH)in patients with ESRD, and analyze the possible influencing factors of PAH.MethodsAmong 128 ESRD patients, 66 cases treated with hemodialysis and 62 cases without hemodialysis were divided into the observation group and control group, respectively.The PAH in two groups was evaluated by echocardiography, and the general data and echocardiographic results between two groups were compared.The observation group was subdivided into the non-PAH group and PAH group, the laboratory tests and cardiac ultrasound indicators were compared between two groups, and which was used to analyze the possible influencing factors of PAH.ResultsThe differences of the serum levels of creatinine, urea nitrogen, albumin, hemoglobin, blood calcium, blood phosphorus, 25(OH)D, intact parathyroid hormone(iPTH), and PAP between the observation group and control group were statistically significant(P < 0.05 to P < 0.01).The incidence rate of PAH in observation group(33.3%)was higher than that in control group(17.7%)(P < 0.05).The differences of the serum iPTH and hemodialysis time between PAH group and non-PAH group were statistically significant(P < 0.05 and P < 0.01).The differences of left atrial diameter, left ventricular end-diastolic diameter, left ventricular mass index and left ventricular ejection fraction between the PAH group and non-PAH group were statistically significant(P < 0.05).The results of unconditional logistic regression analysis showed that the left ventricular end-diastolic diameter, left atrial diameter, left ventricular mass index, left ventricular ejection fraction and(iPTH)were correlated the with occurrence of PAH(P < 0.05).ConclusionsPAH is common in patients with ESRD, and the incidence rate of which in long-term hemodialysis patients is higher, and the changes of left ventricular structure and function are closely related to PAH.