血钠水平与肺动脉高压预后的相关性研究  

Correlation between serum sodium level and prognosis of pulmonary arterial hypertension

作　　者：周红梅[1] 邓晓娴[1] 肖应婷 邱丘[1] 张刚成[1] Zhou Hongmei;Deng Xiaoxian;Xiao Yingting;Qiu Qiu;Zhang Gangcheng(Congenital Heart Disease Center,Wuhan Asian Heart Hospital,Wuhan 430022,China)

机构地区：[1]武汉亚洲心脏病医院先天性心脏病中心,430022

出　　处：《中国心血管杂志》2019年第1期75-78,共4页Chinese Journal of Cardiovascular Medicine

基　　金：武汉市卫生计生委科研基金项目(WX15A11)~~

摘　　要：目的探讨血钠水平与肺动脉高压患者预后的关系。方法回顾性分析2014年1月至2016年12月就诊于武汉亚洲心脏病医院的100例肺动脉高压患者。根据患者血钠水平分为低钠血症组(血钠<135 mmol/L,40例)和正常血钠组(60例),分析血钠水平与肺动脉高压预后的相关性。结果与正常血钠组相比,低钠血症组患者的临床症状更多(82.5%比45.0%,P<0.001)、更易出现水肿(75.0%比27.8%,P<0.001)、住院率更高(72.5%比38.3%,P<0.001)、右心房压更高[(13.4±5.1)mmHg比(8.2±3.6)mmHg,P<0.001]、心脏指数更低[(21.2±8.5)ml/m^2比(34.7±8.9)ml/m^2,P<0.01]、右心室与左心室容积比更大(1.93±0.45比1.31±0.52,P<0.001)和三尖瓣收缩期位移更小[(1.52±0.50)cm比(1.93±0.40)cm,P=0.001],但两组的平均肺动脉收缩压相似[(48.9±8.3)mmHg比(48.5±10.7)mmHg,P=0.542]。结论血钠水平与肺动脉高压患者的病情严重程度和预后均明显相关,低钠血症可能是肺动脉高压患者预后不良的重要指标。Objective To investigate the relationship between serum sodium level and prognosis in patients with pulmonary arterial hypertension(PAH).Methods 100 patients with PAH were enrolled from January 2014 to December 2016 at Wuhan Asia Heart Hospital retrospectively,including 57 patients with PAH associated with congenital heart disease(CHD),29 patients with idiopathic pulmonary arterial hypertension(IPAH)and 14 patients with PAH associated with connective tissue disease(CTD).According to the patient..s blood sodium level,the patients were divided into hyponatremia group(blood sodium<135 mmol/L,40 cases)and normal blood sodium group(60 cases).The correlation between serum sodium level and prognosis of PAH was analyzed.Results Compared with the normal blood sodium group,the patients with hyponatremia had more clinical symptoms(82.5%vs.45.0%,P<0.001),higher incidence of edema(75.0%vs.27.8%,P<0.001),higher hospitalization rate(72.5%vs.38.3%,P<0.001),higher right atrial pressure[(13.4±5.1)mmHg vs.(8.2±3.6)mmHg,P<0.001],lower cardiac output index[(21.2±8.5)ml/m^2 vs.(34.7±8.9)ml/m^2,P<0.01],ratio of right ventricular diameter to the left ventricular diameter(1.93±0.45 vs.1.31±0.52,P<0.001)was higher in hyponatremia group while,and tricuspid annular plane systolic excursion[(1.52±0.5)cm vs.(1.93±0.40)cm,P=0.001]was lower.But the mean pulmonary artery systolic pressure was similar between two groups[(48.9±8.3)mmHg vs.(48.5±10.7)mmHg,P=0.542].Conclusion The level of blood sodium is significantly correlated with the severity and prognosis of patients with PAH.Hyponatremia may be an important indicator for poor prognosis in PAH patients,but more research is needed.

关 键 词：低钠血症 高血压 肺性 右心功能不全 

分 类 号：R544.1[医药卫生—心血管疾病]