高原地区肺动脉高压的相关危险因素分析

Analysis of risk factors for pulmonary arterial hypertension in high-altitude areas

目的:探讨高原地区肺动脉高压(PAH)的相关危险因素。方法:选取符合纳入标准的359例患者作为研究对象,收集患者的一般临床资料及相关实验室检查,进行彩色多普勒超声检查,以肺动脉收缩压(PASP)≥36 mmHg(1 mmHg=0.133 kPa)为界值,分为肺动脉高压组(PAH组,286例)和无肺动脉高压组(对照组,73例)。分析和肺动脉高压有关的指标,以PASP作为因变量,以低密度脂蛋白、血尿酸、血肌酐、血小板、主肺动脉内径作为协变量,进行多因素Logistic回归分析。结果:两组血尿酸、血肌酐、尿素氮、右室舒张末前后径、主肺动脉内径、血小板、血小板压积、低密度脂蛋白比较,差异具有统计学意义(t=-0.63、-8.98、-6.65、-6.56、-2.25、3.18、2.06、2.34,均P<0.05)。PASP与血尿酸、血肌酐、右室前后径、主肺动脉内径均呈正相关(r=0.29、0.20、0.31、0.42,均P<0.05),与低密度脂蛋白、血小板均呈负相关(r=-0.22、-0.13,均P<0.05)。多因素Logistic回归分析显示,血肌酐为肺动脉高压的危险因素(OR=1.044,95%CI:1.019~1.069,P<0.05)。结论:低密度脂蛋白、血小板、血尿酸、血肌酐、右室前后径、主肺动脉内径与高原地区肺动脉高压具有相关性,血肌酐升高为高原地区肺动脉高压的危险因素。

Objective:To explore the possible risk factors associated with pulmonary arterial hypertension(PAH)in high altitude areas.Methods:359 cases of patients who met the inclusion criteria were selected as the research object.The patients′general clinical data and related laboratory tests were collected,and color doppler ultrasound was examined.According to the pulmonary artery systolic pressure PASP≥36 mmHg(1 mmHg=0.133 kPa),the patients were divided into PAH group(286 cases)and non-pulmonary arterial hypertension group(control group,73 cases).Indexes related to PAH were analyzed.Pulmonary systolic blood pressure(PASP)was taken as the dependent variable,and LDL,uric acid,creatinine,platelet,and inner diameter of the main pulmonary artery were taken as the covariates for multivariate Logistic regression analysis.Results:The differences in uric acid,creatinine,urea nitrogen,right ventricular end-diastolic anteroposterior diameter,main pulmonary artery diameter,platelet,platelet deposition,LDL centralized tendency were statistically significant between the two groups(t=-0.63,-8.98,-6.65,-6.56,-2.25,3.18,2.06,2.34,all P<0.05).The PASP was positively correlated with serum uric acid,serum creatinine,anterior and posterior diameter of right ventricle(r=0.29,0.20,0.31,0.42,all P<0.05)and PASP was both negatively with low density lipoprotein,platelet(r=-0.22,-0.13,all P<0.05)in patients.Multivariate Logistic regression analysis showed that serum creatinine were independent risk factors for PAH(OR=1.044,95%CI:1.019-1.069,P<0.05).Conclusion:The LDL,platelet,uric acid,serum creatinine,anterior and posterior diameter of right ventricle are associated with PAH in high altitude areas.Increased serum creatinine is a predictor of PAH in high altitude areas.