【摘要】：目的:探討血液透析(HD)患者并發(fā)肺動脈高壓(PH)的相關因素及預后。方法:選取2014年6月之前在我院血液透析中心行HD治療的患者90例進行前瞻性隨訪1年,比較并發(fā)PH(PH組)和無PH(非PH組)患者的臨床資料、心臟彩超、血管鈣化相關指標及預后。結(jié)果:PH組的血白蛋白水平、Kt/V顯著低于非PH組,其血尿素氮和肌酐顯著高于非PH組(P0.05)。兩組血管鈣化相關指標如冠脈鈣化積分、腹主動脈和心臟瓣膜鈣化、甲狀旁腺激素、鈣、磷、堿性磷酸酶、25羥維生素D比較差異均無統(tǒng)計學意義。PH組的左室收縮末期、舒張末期內(nèi)徑、左房內(nèi)徑、左室質(zhì)量指數(shù)均顯著大于非PH組,PH組左室射血分數(shù)顯著低于非PH組(P0.05)。Logistic回歸分析結(jié)果顯示,左房內(nèi)徑的增加與HD患者并發(fā)PH顯著相關(OR=2 538.116,P=0.000)。PH組的全因死亡率高于非PH組,但差異無統(tǒng)計學意義。PH組中急性心功能不全發(fā)生率(35.13%)顯著高于非PH組。結(jié)論:HD患者并發(fā)PH者較為常見,低白蛋白血癥、尿毒癥毒素、心臟結(jié)構(gòu)及功能異常以及容量負荷可能參與HD患者并發(fā)PH的發(fā)生。
[Abstract]:Objective: to investigate the related factors and prognosis of (PH) complicated with pulmonary hypertension in patients with (HD). Methods: 90 patients treated with HD in hemodialysis center of our hospital before June 2014 were followed up prospective for 1 year. The clinical data, cardiac color Doppler ultrasound, vascular calcification and prognosis of patients complicated with PH (PH and non-PH (non-PH group) were compared. Results: the levels of serum albumin and Kt/V in PH group were significantly lower than those in non-PH group, and the blood urea nitrogen and creatinine in PH group were significantly higher than those in non-PH group (P 0.05). There was no significant difference in vascular calcification between the two groups, such as coronary artery calcification score, calcification of abdominal aortic and cardiac valve, parathyroid hormone, calcium, phosphorus, alkaline phosphatase and 25 hydroxyvitamin D. the left ventricular end-systolic diameter, end-diastolic diameter, left atrial diameter and left ventricular mass index in PH group were significantly higher than those in non-PH group. The left ventricular ejection fraction in PH group was significantly lower than that in non-PH group (P 0.05). Logistic regression analysis showed that the increase of left atrial diameter was significantly correlated with PH in HD patients (OR=2 538.116, P 鈮，

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