摘要
Abstract
Objective To investigate the incidence of pulmonary hypertension ( PHT ) and its correlative influential factors in patients receiving long - term maintenance hemodialysis ( MHD ), to give early diagnoses and intervention. Methods A retrospective analysis was performed on complete clinical data of 84 patients admitted for over - 1 - year MHD with internal arteriovenous fistula as hemodialysis vascular access and with echocardiography pulmonary artery systolic pressure ( PASP ) > 35 mm Hg for PHT diagnosis. The clinical data, laboratory parameters, cardiac ultrasound parameters were compared between groups PHT, non -PHT, and PHT incidence, PASP between patients with and without dialysis ages ( DA ), primary diseases, clinical manifestations. Multifactor Logistic regression analysis was used to find related factors of PHT. Results ( 1 ) Thirty -six ( 42. 9% ) patients were diagnosed as PHT with mean PASP ( 53. 1 ±11.8 ) mm Hg. DA was longer, hemoglobin ( Hb ) lower, left atrial diameter, left ventricular end - diastolic diameter, main pulmonary artery, right atrial diameter, left ventricular ejection fraction ( LVEF ) < 50% , diastolic early and late diastolic peak velocity ratio ( E/A ) and proportion of valvular calcification higher, LVEF lower in PHT group than in non -PHT group, the differences were significant ( P <0. 05 ). ( 2 ) PHT incidence and PASP were higher in DA > 5 - year group than in < 2 - year group, higher in patients with dyspnea than in those without, the difference was significant ( P <0. 05 ). There was no difference in PHT incidence or PASP between MHD patients with diabetes as primary disease and those without diabetes. Logistic regression analysis showed that Hb, valvular calcification, E/A had regressive relationship to MHD combined with PHT ( P < 0. 05 ). Conclusion The incidence of PHT is 42. 9% in MHD patients, and remarkably higher in DA > 5 - year patients. Anemia, metastatic calcification, left ventricular diastolic dysfunction may be involved in the occurrence of PHT in MHD patients.关键词
肾透析/高血压,肺性/超声心动描记术/危险因素Key words
Renal dialysis/ Hypertension, pulmonary/ Echocardiography/ Risk factors分类
医药卫生
