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维持性透析的终末期肾病患者肺动脉高压的患病率及其相关因素:一项回顾性研究

The Prevalence of Pulmonary Hypertension Among Maintenance Dialysis Patients With ESRD and Its Associated Factors: A Retrospective Study.

作者信息

Zhang Ying, Ding Xiao-Han, Rao Rongsheng, Wang Yiqin, Pang Fang, Tang Sha, Nie Ling, Bian Shi-Zhu

机构信息

The Key Laboratory for the Prevention and Treatment of Chronic Kidney Disease of Chongqing, Department of Nephrology, Kidney Center of People's Liberation Army, Xinqiao Hospital, Army Medical University (Third Military Medical University), Chongqing, China.

Department of Health Care and Geriatrics, The 940th Hospital of Joint Logistics Support of People's Liberation Army, Lanzhou, China.

出版信息

Front Med (Lausanne). 2020 Dec 4;7:570874. doi: 10.3389/fmed.2020.570874. eCollection 2020.

Abstract

To determine the prevalence of pulmonary hypertension (PH) and its associated factors among end-stage renal disease (ESRD) patients who underwent maintenance dialysis. A total of 491 patients received echocardiography examinations and underwent pulmonary artery systolic pressure (PASP) assessments. A subgroup of 283 patients were subjected to plasma creatinine (Cr) and blood urea nitrogen concentration (BUN) tests, routine blood examinations and electrolyte analysis. First, we compared the differences in echocardiographic, Cr and BUN, blood routine and electrolyte parameters between PH and non-PH groups. The correlations between PASP and the parameters mentioned above were also analyzed. Furthermore, univariate and adjusted logistic regression analyses were performed to identify the independent associated factors. The incidence of PH among ESRD patients who were treated with maintenance dialysis was 34.6%. Most of the echocardiographic parameters, including end-diastolic internal diameters of the left atrium, left ventricle, right atrium, and pulmonary artery, as well as interventricular septum mobility, left ventricular posterior wall mobility, fractional shortening, stroke volume and left ventricle ejection fraction (LVEF), were associated with PH. Furthermore, Mg ( = 0.037) and Cl ( = 0.043) were significantly associated with PASP. However, after adjustments were made in the regression analysis, only internal diameters of the left atrium, right atrium, and LVEF were independently associated with PH. PH is prevalent, with a relatively high incidence among ESRD patients who undergo maintenance dialysis. The sizes of the left and right atria as well as LVEF were independently associated with PH, but further cohort and basic mechanistic studies are needed to confirm this finding.

摘要

确定接受维持性透析的终末期肾病(ESRD)患者中肺动脉高压(PH)的患病率及其相关因素。共有491例患者接受了超声心动图检查并进行了肺动脉收缩压(PASP)评估。283例患者的亚组接受了血浆肌酐(Cr)和血尿素氮浓度(BUN)检测、血常规检查和电解质分析。首先,我们比较了PH组和非PH组在超声心动图、Cr和BUN、血常规和电解质参数方面的差异。还分析了PASP与上述参数之间的相关性。此外,进行单因素和校正逻辑回归分析以确定独立相关因素。接受维持性透析治疗的ESRD患者中PH的发生率为34.6%。大多数超声心动图参数,包括左心房、左心室、右心房和肺动脉的舒张末期内径,以及室间隔运动、左心室后壁运动、缩短分数、每搏输出量和左心室射血分数(LVEF),均与PH相关。此外,Mg(=0.037)和Cl(=0.043)与PASP显著相关。然而,在回归分析中进行校正后,只有左心房、右心房内径和LVEF与PH独立相关。PH很常见,在接受维持性透析的ESRD患者中发病率相对较高。左、右心房大小以及LVEF与PH独立相关,但需要进一步的队列研究和基础机制研究来证实这一发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d68c/7746851/8460df90b1dd/fmed-07-570874-g0001.jpg

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