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血液透析患者的肺动脉高压及其决定因素:一项基于医院的横断面研究。

Pulmonary Hypertension in Hemodialysis Patients and Its Determinants: A Hospital Based Cross-Sectional Study.

作者信息

Yu Qingfei, Zhang Qin

机构信息

Department of Nephrology, Shandong Provincial Third Hospital, Shandong University, Jinan, Shandong, People's Republic of China.

出版信息

Int J Gen Med. 2024 Sep 7;17:3919-3926. doi: 10.2147/IJGM.S471779. eCollection 2024.

Abstract

PURPOSE

Pulmonary hypertension (PH) is a serious complication in hemodialysis patients, which is associated with a significantly increased risk of morbidity and mortality. The present study aims to investigate PH frequency and associated factors in patients undergoing maintenance hemodialysis.

PATIENTS AND METHODS

This cross-sectional study was conducted in the hemodialysis department of the Shandong Provincial Third Hospital, China, from January 2016 to December 2022. A total of 167 consecutive patients who underwent regular hemodialysis treatment for at least three months were included in the study. Patients with a systolic pulmonary artery pressure (sPAP) value >35 mmHg at rest were considered to have PH. The relationship between PH and various demographic, laboratory, and echocardiographic parameters was evaluated.

RESULTS

A total of 93 patients (55.7%) were diagnosed with PH. Multivariate logistic regression analysis indicated that low serum levels of albumin (OR 0.89, 95% CI 0.82-0.98, p = 0.017), low serum levels of triglycerides (OR 0.32, 95% CI 0.15-0.69, p = 0.003), and high right atrial diameter (OR 1.19, 95% CI 1.04-1.37, p = 0.011) were significantly associated with an increased risk of PH.

CONCLUSION

PH is a common finding in hemodialysis patients and is independently associated with serum levels of albumin, serum levels of triglyceride, and right atrial diameter; this suggests that evaluating these non-invasive and relatively easily available parameters may be useful in identifying patients with a high risk of PH. However, further studies are required to confirm these findings.

摘要

目的

肺动脉高压(PH)是血液透析患者的一种严重并发症,与发病和死亡风险显著增加相关。本研究旨在调查维持性血液透析患者的PH发生率及相关因素。

患者与方法

本横断面研究于2016年1月至2022年12月在中国山东省立第三医院血液透析科进行。共有167例连续接受规律血液透析治疗至少三个月的患者纳入研究。静息时收缩期肺动脉压(sPAP)值>35 mmHg的患者被认为患有PH。评估了PH与各种人口统计学、实验室和超声心动图参数之间的关系。

结果

共有93例患者(55.7%)被诊断为PH。多因素逻辑回归分析表明,低血清白蛋白水平(OR 0.89,95%CI 0.82 - 0.98,p = 0.017)、低血清甘油三酯水平(OR 0.32,95%CI 0.15 - 0.69,p = 0.003)和右心房增大(OR 1.19,95%CI 1.04 - 1.37,p = 0.011)与PH风险增加显著相关。

结论

PH在血液透析患者中很常见,并且与血清白蛋白水平、血清甘油三酯水平和右心房直径独立相关;这表明评估这些非侵入性且相对容易获得的参数可能有助于识别PH高危患者。然而,需要进一步研究来证实这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/282a/11390829/825afd406ce7/IJGM-17-3919-g0001.jpg

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