本文關(guān)鍵詞： 血液透析 肺動(dòng)脈高壓 超聲心動(dòng)圖 NT-proBNP PTH　出處：《山西醫(yī)科大學(xué)》2014年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：探討血液透析患者肺動(dòng)脈高壓(pulmonary hypertension, PH)發(fā)生情況,以及影響疾病發(fā)生發(fā)展的相關(guān)因素,總結(jié)其臨床特點(diǎn),以利于早期診斷肺動(dòng)脈高壓及并給予臨床干預(yù)。 方法：收集2013年1月至2014年1月就診于我院的60例資料完整的血液透析治療患者資料,通過超聲心動(dòng)圖檢查測算肺動(dòng)脈收縮壓(systolic pulmonary artery pressure, PASP),根據(jù)PASP值分為兩組,PASP35mmHg(1mmHg=0.133kPa)為肺動(dòng)脈高壓(PH)組,PASP≤35mmHg為非PH組,觀察臨床指標(biāo)、實(shí)驗(yàn)室指標(biāo)和心臟其他結(jié)構(gòu)及功能方面指標(biāo)等相關(guān)檢查,采用多種統(tǒng)計(jì)學(xué)分析方法,比較兩組之間是否存在統(tǒng)計(jì)學(xué)差異,并對(duì)相關(guān)因素進(jìn)行Logistic回歸分析。 結(jié)果：60例患者中PASP升高的占22例,發(fā)生率為36.67%(22/60)。PH組與非PH組比較,血漿甲狀旁腺素(parathyroid hormone, PTH)[(275.40±133.06) pg/ml vs(177.46±133.86)pg/ml]、N末端前鈉尿肽(N-terminal pro-brain natriuretic peptide, NT-proBNP)[(11122.77±6690.50) ug/L vs (6339.44±5529.50) ug/L],差異有統(tǒng)計(jì)學(xué)意義(P0.05)。PH組肺動(dòng)脈根部徑[(28.48±4.81) mm vs (24.97±3.04)mm]、左室舒張末內(nèi)徑[(58.82±5.05) mm vs (51.95±6.00) mm]、左房前后徑[(43.55±5.82) mm vs (36.84±6.23) mm]、右室前后徑[(23.86±4.24)mm vs(21.37±2.45)mm]高于非PH組,左室射血分?jǐn)?shù)PH組[(55.68±13.03)%vs(62.29±10.13)%]低于非PH組,差異有統(tǒng)計(jì)學(xué)意義(P0.01或P0.05)。 Logistic回歸分析顯示,左心室舒張末內(nèi)徑和左房前后徑與血液透析患者并發(fā)PH情況顯著相關(guān)。 結(jié)論：1.PH是血液透析患者常見的嚴(yán)重并發(fā)癥之一；2.繼發(fā)性甲狀旁腺功能亢進(jìn)以及一些引起心力衰竭的因素可能參與了血液透析患者并發(fā)PH的發(fā)生發(fā)展過程；3.左心疾病與PH發(fā)病情況存在相關(guān)關(guān)系；4.血液透析合并PH患者病情重且復(fù)雜,臨床上需根據(jù)每個(gè)患者個(gè)體的整體狀況來做出評(píng)估。
[Abstract]:Objective: to investigate the incidence of pulmonary hypertension (PH1) in hemodialysis patients and the related factors affecting the development of the disease. The clinical features were summarized to facilitate the early diagnosis and clinical intervention of pulmonary hypertension. Methods: 60 patients with hemodialysis were collected from January 2013 to January 2014 in our hospital. Systolic pulmonary artery pressure (PASP) was measured by echocardiography. According to the PASP value, two groups were divided into two groups: PASP35mm HgG 1 mm HgG 0.133 KPA) group (PASP35 mmHg 鈮，

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