慢性肾病合并慢性心力衰竭患者肺动脉收缩压水平与死亡关系的分析  

Relationship between pulmonary artery pressure and death with chronic kidney disease complicated with chronic heart failure

作　　者：李勇峰 刘曙艳 周雪红 王小青 张慧 LI Yongfeng;LIU Shuyan;ZHOU Xuehong;WANG Xiaoqing;ZHANG Hui(Department of Endocrinology,The First Affiliated Hospital of Henan Polytechnic University ( Jiaozuo Second People's Hospital),Jiaozuo 454000,China)

机构地区：[1]河南理工大学第一附属医院焦作市第二人民医院内分泌科一区

出　　处：《心肺血管病杂志》2019年第7期731-735,共5页Journal of Cardiovascular and Pulmonary Diseases

摘　　要：目的:评估396例慢性肾病(CKD)合并慢性心力衰竭(CHF)患者的肺动脉收缩压(PASP)水平与死亡的关系。方法:收集2013年1月到2017年5月,就诊我院的CKD合并CHF患者396例,应用超声心动图测定所有患者的肺动脉收缩压(PASP),根据有无肺动脉高压(PH),将患者分为PH组(PASP≥35mmHg)(1mmHg=0.133kPa)和非PH组(PASP<35mmHg),比较两组基线资料、血清Cr、HGB、NT-proBNP水平、LVEF,FEV1/FVC,并计算肾小球滤过率(GFR)及病死率情况,并对影响患者死亡因素进行Logistic回归分析。结果:PH组患者入院时年龄、性别比、收缩压、BMI及合并症情况、FEV1/FVC间,差异无统计学意义(P均>0.05),NYHAIV级、NT-proBNP水平高于非PH组患者(P均<0.05);HGB、GFR及LVEF水平低于非PH组患者(P均<0.05)。对影响患者死亡因素进行Logistic回归分析显示,PH是CKD合并CHF患者死亡的危险因素。结论:肺动脉高压是慢性肾病合并慢性心力衰竭患者死亡的危险因素。Objective: To assess the relationship between pulmonary artery systolic pressure ( PASP) and prognosis in 396 patients of chronic kidney disease ( CKD) complicated with chronic heart failure ( CHF). Methods: We analyzed the data of 396 adult patients with CKD complicated with CHF in our hospital between January 2013 to May 2017. The PASP was measured by echocardiography in all patients. The patients were divided into Pulmonary hypertension( PH) group ( PASP≥35 mm Hg) and non PH group ( PASP <35 mm Hg) according to the presence or absence of PH. The levels of serum creatinine,HGB,NT-pro BNP,LVEF were compared between the two groups,and the glomerular filtration rate ( GFR) and mortality were calculated And the logistic regression analysis of the factors affecting the patient' s death. Results: There was no significant difference in age,sex ratio,systolic blood pressure and BMI between the two groups ( P> 0. 05). The levels of NYHA class IV and NT-pro BNP were higher than those of non PH group ( P<0. 05) Hemoglobin,GFR and LVEF were lower than those in non PH group ( P<0. 05).Logistic regression analysis of factors affecting patient death showed that PH was an independent risk factor for death in CKD patients with CHF. Conclusions: PASP is an independent risk factor for death in patients of CKD complicated with chronic heart failure.

关 键 词：肺动脉收缩压 慢性肾病 慢性心力衰竭 预后 

分 类 号：R54[医药卫生—心血管疾病]