长期维持性血液透析患者并发肺动脉高压的临床分析

Clinical analysis of pulmonary hypertension in patients with long -term maintenance hemodialysis

目的探讨维持性血液透析(MHD)患者肺动脉高压(PH)的临床特点及其危险因素。方法选择MHD的终末期肾病患者125例,按有无PH分为PH组和非PH组,比较两组间的年龄、血管通路方式、血压及透析前血液检验,并于透析次日行超声心动图检查,并对相关危险因素行Logistic多元回归分析。结果①PH组中采用动静脉内瘘的比例显著高于非PH组(P<0.01)。②PH组的PTH水平、肺动脉内径、右室横径、右房横径、左室舒张末内径及左室收缩末内径均显著大于非PH组(P<0.01或P<0.05)。③PH组的左室射血分数(LVEF)值低于非PH组(P<0.01)。④Logistic多元回归分析结果显示,血管通路方式为MHD并发PH的主要危险因素。结论血管通路方式为MHD并发PH的危险因素,通过纠正此因素有利于早期防治PH。

Objective To investigate the characteristics and risk factors of pulmonary hypertension in patients on long- term maintenance hemodialysis （MHD）. Methods The 125 cases of MHD were divided into PH group and non-PH group.The age, blood pressure, vascular access way, Bp and blood tests results were compared between two groups. E- chocardiography was performed in the next day after hemodialysis.Related factors were analyzed by Logistic regression analysis. Results ①In PH group,the rate of arteriovenous fistula was significantly higher than that of the non-PH group （P 〈 0.01）.②There were significant differences of the PTI-I level, pulmonary artery diameter,right ventricular di- ameter,right atrial diameter,left ventricular end diastolic diameter and left ventricular end-systolic diameter between two groups （P 〈 0.01 or P 〈 0.05）. ③The LVEF value of PH group was lower than that of non-PH group （P 〈 0.01）. ④Multivariate Logistic regression analysis showed that vascular access way was the risk factor of PH. Conclusion Vascular access way was the risk factor of PH,and correcting this risk factor may be in favor of early preventing and treating the PH.