腹膜透析1年内患者肺动脉高压的危险因素分析

Analysis of risk factors of pulmonary hypertension in patients with peritoneal dialysis within one year

目的探讨腹膜透析1年内患者肺动脉高压(PH)的发生情况和危险因素。方法选取2014年1月31日至2017年12月31日我院符合要求腹膜透析患者,收集其一般资料、实验室及超声心动图检验检查结果,将肺动脉压>35 mmHg诊断为PH,统计分析PH的发生率和危险因素。结果111例腹膜透析患者中PH发生率为20.72%,PH组患者存在显著的高收缩压、高iPTH,左房、右室及右室内径增加,且合并心衰比例也增高,而血红蛋白、清蛋白水平则降低。Logistic回归分析显示,高收缩压及增加的右室内径是肺动脉高压的危险因素。结论PH在早期腹膜透析患者中有较高发病率,收缩压控制不良和右室内径增加是影响PH的主要危险因素。

Objective To investigate the occurrence and risk factors of pulmonary hypertension(PH)in patients with peritoneal dialysis within one year.Methods The peritoneal dialysis patients in our hospital who met the requirements from January 31,2014 to December 31,2017 were selected.Their general data,laboratory and echocardiographic examination results were collected.The pulmonary artery pressure>35 mmHg was diagnosed as PH.The incidence and risk factors of PH were statistically analyzed.Results Among 111 peritoneal dialysis patients,the incidence of PH was 20.72%.Patients in the PH group had significant high systolic blood pressure,high iPTH,increased left atrium,right ventricle,and right ventricular diameter.The proportion of combined heart failure also increased,while hemoglobin and serum protein levels were reduced.Logistic regression analysis showed that high systolic blood pressure and increased right ventricular diameter were risk factors for pulmonary hypertension.Conclusion PH has a higher incidence in early peritoneal dialysis patients.Poor systolic blood pressure control and increased right ventricular diameter are the main risk factors affecting PH.