维持性腹膜透析患者并发肺动脉高压的临床研究

滕兰波; 常明; 刘书馨; 张运刚; 王凌溪; 储文文

doi:10.13201/j.issn.1001-1439.2019.04.020

维持性腹膜透析患者并发肺动脉高压的临床研究

- 大连市中心医院肾内科(大连, 116033)

详细信息

通讯作者: 常明,E-mail:mingchang@yeah.net

中图分类号: R541.3

收稿日期: 2018-09-11

Clinical study of pulmonary arterial hypertension in maintenance peritoneal dialysis patients

- Department of Nephrology, Dalian Central Hospital, Dalian, 116033, China

More Information

Corresponding author: CHANG Ming, E-mail: mingchang@yeah.net

Received Date: 11 September 2018

摘要

摘要: 目的：探讨维持性腹膜透析（MPD）患者并发肺动脉高压（PAH）的危险因素，评估PAH对MPD患者生存预后的影响。方法：回顾性分析2009-09-2016-09开始持续不卧床腹膜透析（CAPD）治疗并规律随访患者的临床资料，比较PAH （+）组和PAH （-）组患者的各项临床指标及心脏超声指标，采用二元Logistic回归方程分析PAH发生的危险因素，采用Cox回归模型分析MPD患者死亡的危险因素。结果：180例患者符合入组条件，PAH （+）组23例（12.78%），PAH （-）组157例（87.22%）。PAH （+）组的收缩压明显高于PAH （-）组[（163.13±26.20） mmHg∶（150.01±28.65） mmHg，P=0.04]，血红蛋白及血浆白蛋白均明显低于PAH （-）组[（89.83±21.37） g/L∶（102.71±21.67） g/L，P=0.008；（30.15±3.44） g/L∶（32.74±4.45） g/L，P=0.008]，左室射血分数显著低于PAH （-）组[（48.74±9.44）%∶（58.63±7.52）%，P<0.001]，左房内径、左室舒张末期内径均大于PAH （-）组，差异有统计学意义；Logistic回归分析显示收缩压升高、血浆白蛋白和左室射血分数下降是MPD患者并发PAH的危险因素。Cox回归分析显示PAH是MPD患者死亡的独立危险因素。结论：本中心MPD患者PAH的发生率虽不高，但仍是影响患者生存的危险因素之一。应高度重视MPD患者PAH的早期诊断和早期干预。
- 腹膜透析 /
- 肺动脉高压 /
- 危险因素 /
- 死亡
Abstract: Objective: To investigate the risk factors of Pulmonary Arterial Hypertension (PAH) in patients with maintenance peritoneal dialysis (MPD), and evaluate the influence of PAH on survival prognosis of MPD patients.Method: Clinical data were analysed from patients who began continuous ambulatory peritoneal dialysis from September 2009 to September 2016 and followed-up regularly in Dalian Municipal Central Hospital retrospectively, clinical parameters and echocardiographic indexes were compared between PAH (+) group and PAH (-) group.The risk factors of PAH in MPD patients were analyzed using Logistic analysis, and the risk factors of death were analyzed as well using Cox regression analysis.Result: The 180 patients met the criteria for admission, 23 (12.78%) patients in PAH(+) group.The systolic blood pressure(SBP) in PAH (+) group was significantly higher than that of PAH (-) group[(163.13±26.20) mmHg vs (150.01±28.65) mmHg, P=0.04], hemoglobin and serum albumin(Alb) were significantly lower than those of PAH (-) group[(89.83±21.37) g/L vs (102.71±21.67) g/L, P=0.008;(30.15±3.44) g/L vs (32.74±4.45) g/L, P=0.008], left ventricular ejection fraction (LVEF) was significantly lower than that of PAH (-) group[(48.74±9.44)% vs (58.63±7.52)%, P<0.001], left ventricular end diastolic diameter and left atrial diameter were greater than PAH (-) group.Logistic regression analysis showed that elevated SBP and decreased plasma Alb and LVEF were risk factors for PAH.Cox regression analysis showed that PAH was an independent risk factor for death in MPD patients.Conclusion: Although the incidence of PAH in MPD patients is not high, it is still one of the risk factors that affect mortality.We should pay great attention to early diagnosis and intervention of PAH.
- peritoneal dialysis /
- pulmonary arterial hypertension /
- risk factor /
- mortality

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