早期慢性肾脏病患者肺动脉压变化与心脏结构功能的相关性

Relationship between pulmonary arterial pressure changes in early-stage chronic kidney disease with cardiac structure and function

目的探讨早期慢性肾脏病（CKD）肺动脉压（PAP）变化及其与心脏结构功能的相关性。方法将315例早期cKD患者和51名健康对照者PAP水平进行比较分析，探讨其与血浆脑钠肽（BNP）及左心室质量指数（LVMI）等心脏结构功能指标的相关性。结果①与对照组比较，早期CKD组PAP明显升高[（31．87±8．39）mmHg比（29．43±3．71）mmHg，P〈o．01]；肺动脉高压（PHT）发生率12．06％；PHT在CKD1期已经出现，随肾功能恶化愈加严重。CKD2期始，InBNP和LVMI等心脏指标显著增高（P〈0．05）。LVMI和InBNP均是影响PAP的独立危险因素。结论早期CKD已出现PHT，PHT随肾功能恶化而增高，并与心脏结构功能变化密切相关。

Objective To explore the pulmonary arterial pressure（PAP） level in patients with early-stage chronic kidney disease（CKD） and its relationship to indexes of cardiac structure and func- tion. Methods 315 cases of early-stage CKD and 51 healthy controls were enrolled. The PAP level in each group was measured, and its correlation with indexes of cardiac structure and function such as LVMI,BNP was analyzed. Results （1）PAP level in early-stage CKD group was significantly higher than in control group [-（31.87 ± 8.39） vs （29. 43 ± 3.71） mmHg,P〈0. 011.12. 06% patients in early- stage CKD group were accompanied with pulmonary hypertension（PHT）. PHT was observed in stage 1 of CKD, and deteriorated with progression of kidney injury; （2）Compared with control group, lnB- NP, LVMI and other cardiac indexes in early-stage CKD group were increased from stage 2 of CKD （P〈0.05）. LVMI and lnBNP were both independent risk factors of PAP. Conclusions Pulmonary hy- pertension occurs in early-stage CKD. PAP level keeps increasing with progression of renal injury. PAP is related to indexes of cardiac structure and function.