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毛细血管前性肺动脉高压患者的肾功能不全、肝功能损害及脂质代谢异常

Kidney Dysfunction, Hepatic Impairment, and Lipid Metabolism Abnormalities in Patients with Precapillary Pulmonary Hypertension.

作者信息

Iancu Dragos Gabriel, Varga Andreea, Cristescu Liviu, Dumbrava Robert Adrian, Stoica Florin, Moldovan Diana Andreea, Suteu Radu Adrian, Tilea Ioan

机构信息

Doctoral School, G.E. Palade University of Medicine, Pharmacy, Science and Technology of Targu Mures, 540142 Targu Mures, Romania.

Department of Internal Medicine II, Emergency Clinical County Hospital, 540042 Targu Mures, Romania.

出版信息

Diagnostics (Basel). 2024 Aug 21;14(16):1824. doi: 10.3390/diagnostics14161824.

Abstract

BACKGROUND

Pulmonary hypertension (PH) is a global health issue that has profound medical and research implications.

METHODS

This retrospective study examined changes in renal and liver function, as well as lipid metabolism, over a 12-month period in 49 adult patients with pulmonary arterial hypertension (PAH) and chronic thromboembolic pulmonary hypertension (CTEPH). All cases were admitted, managed, and followed up with in the PH Center, County Emergency Clinical Hospital of Targu Mures, Romania.

RESULTS

Kidney dysfunction was observed in 12.24% of cases at baseline, decreasing to 8.16% at 12 months, and CTEPH patients were more affected. In particular, CTEPH patients exhibited an improvement in renal function, confirmed by an increase in their glomerular filtration rates. Hepatic impairment was present in 57.14% of subjects at baseline, declining to 42.86% at 12 months, with significant improvements noted in the PAH group. Lipid metabolic dysregulations were experienced by 22.45% of all patients at baseline, decreasing to 16.33% at 6 months, with a slow elevation to 24.49% at 12 months, but with no statistically significant differences. Pharmacological regimens were adjusted in accordance with the PH groups, a patient's functional and clinical response, and laboratory tests.

CONCLUSIONS

Our results demonstrate the multi-organ damage in PH and the importance of individualized treatment approaches.

摘要

背景

肺动脉高压(PH)是一个具有深远医学和研究意义的全球性健康问题。

方法

这项回顾性研究调查了49例成年肺动脉高压(PAH)和慢性血栓栓塞性肺动脉高压(CTEPH)患者在12个月期间肾功能、肝功能以及脂质代谢的变化。所有病例均在罗马尼亚特尔古穆列什县急诊临床医院的肺动脉高压中心入院、治疗及随访。

结果

基线时12.24%的病例出现肾功能不全,12个月时降至8.16%,CTEPH患者受影响更大。特别是,CTEPH患者肾功能有所改善,肾小球滤过率增加证实了这一点。基线时57.14%的受试者存在肝功能损害,12个月时降至42.86%,PAH组有显著改善。所有患者中22.45%在基线时出现脂质代谢失调,6个月时降至16.33%,12个月时缓慢升至24.49%,但无统计学显著差异。根据肺动脉高压分组、患者的功能和临床反应以及实验室检查调整药物治疗方案。

结论

我们的结果表明肺动脉高压存在多器官损害以及个体化治疗方法的重要性。

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