低钠血症与肺动脉高压预后的相关性研究

Correlation between Hyponatremia and Prognosis of Patients with Pulmonary Arterial Hypertension

目的探讨低钠血症与肺动脉高压(pulmonary arterial hypertension,PAH)预后的关系。方法对2009年1月—2011年11月武汉亚洲心脏病医院随访的PAH 50例的临床资料进行回顾性分析。结果低血钠组心率、右心房压、右心房面积指数、右心室面积指数、三尖瓣返流程度、右心房直径/左心房直径、右心室容积/左心室容积高于正常血钠组,心输出量指数、右心室每搏量指数、心输出量与肺动脉收缩压比值、三尖瓣环收缩期位移距离和左心室直径低于正常血钠组(P<0.05,P<0.01)。正常血钠组和低钠血症组1年和2年的存活率分别是93.33%、83.33%和50.00%、20.00%,低血钠组病死率高于正常血钠组(P<0.01)。结论血钠水平与PAH患者的病情严重程度及预后明显相关,低钠血症是PAH患者预后不良的重要指标。

Objective To explore the correlation between hyponatremia and the prognosis of patients with pulmonary arterial hypertension（ PAH）. Methods Clinical data of 50 PAH patients during January 2009 and November2011 in Wuhan Asian Heart Hospital was retrospectively analyzed. Results Compared with those in normal serum sodium group,the values of heart rate（ HR）,right atrial pressure（ RAP）,right atrial area index（ RAAI）,right ventricular area index（ RVAI）,tricuspid regurgitation（ TR）,ratio of right atrial diameter to left atrium diameter（ RAD /LAD） and ratio of right ventricular end-diastolic volume to left ventricular end-diastolic volume（ RVEDV /LVEDV） were significantly higher in hyponatremia group,while the values of stroke volume index（ SVI）,right ventricular stroke work index（ RVSWI）,ratio of stroke volume to pulmonary arterial systolic pressure（ SV/PP）,tricuspid annular plane systolic excursion（ TAPSE） and left ventricle diameter（ LVD） were significantly lower（ P〈 0. 05,P〈 0. 01）. The one-year and two-year of survival rates in normal sodium group and hyponatremia group were 93. 33% 83. 33% and 50. 00% 20. 00% respectively,and the fatality rate in normal sodium group was significantly higher than that in hyponatremia group（ P〈 0.01）. Conclusion Serum sodium level is significantly associated with condition＇s severity and prognosis of patients with pulmonary arterial hypertension,and therefore hyponatremia is an important indicator of poor prognosis in PAH patients.