肝硬化门静脉性肺动脉高压患者的临床特点及危险因素分析  

Clinical Characteristics and Risk Factors of Patients With Cirrhotic Portopulmonary Hypertension

作　　者：张波[1] 刘增长[1] 殷跃辉[1] 杜华安[1] ZHANG Bo;LIU Zengzhang;YIN Yuehui;DU Huaan(Department of Cardiology,The Second Affiliated Hospital of Chongqing Medical University,Chongqing(401336),China)

机构地区：[1]重庆医科大学附属第二医院心血管内科,重庆市401336

出　　处：《中国循环杂志》2021年第6期591-595,共5页Chinese Circulation Journal

摘　　要：目的:分析肝硬化门静脉性肺动脉高压(PoPH)患者的临床特点及危险因素。方法:回顾性地初步筛选了2016年1月至2018年12月在重庆医科大学附属第二医院住院的1381例肝硬化患者,二次筛选出合并门静脉高压的患者428例,根据是否合并肺动脉压力升高分为PoPH组和非PoPH组,通过分析临床资料采用Logistic回归分析评估PoPH的危险因素。结果:428例肝硬化门静脉高压患者中有32例(7.5%)合并肺动脉压力升高。多因素Logistic回归分析结果显示,女性(OR=1.89,95%CI:1.16~4.26,P=0.034)、自身免疫性肝病(OR=4.28,95%CI:1.65~11.07,P=0.003)及低血红蛋白浓度(OR=0.97,95%CI:0.92~0.99,P=0.041)均是肝硬化门静脉高压患者发生PoPH的危险因素,而与肝功能异常的严重程度无关。结论:PoPH为门静脉高压的严重并发症,本研究中PoPH患病率为7.5%,女性、自身免疫性肝病及低血红蛋白浓度为肝硬化门静脉高压患者发生PoPH的危险因素。Objectives:To analyze the clinical characteristics and risk factors of patients with cirrhotic portopulmonary hypertension(PoPH).Methods:1381 cirrhotic patients who were hospitalized in the Second Affiliated Hospital of Chongqing Medical University from January 2016 to December 2018 were prescreened retrospectively,428 patients with portal hypertension were enrolled into the study.The enrolled patients were divided into PoPH group and non-PoPH group according to the presence or absence of elevated pulmonary arterial pressure(PAP).Clinical data were collected and analyzed,and multivariate logistic regression analysis was performed to identify the independent risk factors of PoPH.Results:PoPH was diagnosed in 32 out of the 428 patients(7.5%)with cirrhosis and portal hypertension.After analyzing the baseline clinical data,variables as female,diabetes,hepatitis B virus infection,autoimmune liver disease,alcoholic liver disease,history of transjugular intrahepatic portosystemic shunt(TIPS),Child-Pugh classification and hemoglobin concentration were entered into multivariate logistic regression analysis model,which demonstrated that female(OR=1.89,95%CI:1.16-4.26,P=0.034),autoimmune liver disease(OR=4.28,95%CI:1.65-11.07,P=0.003)and low hemoglobin concentration(OR=0.97,95%CI:0.92-0.99,P=0.041)were the independent risk factors of PoPH in this patient cohort.Severity of liver dysfunction was not a risk factor of PoPH.Conclusions:PoPH is a severe complication of portal hypertension,which is often ignored in clinical practice,and the prevalence rate of PoPH is 7.5%in this cohort.Female,autoimmune liver disease and low hemoglobin concentration are the independent risk factors of PoPH in patients with cirrhosis and portal hypertension.

关 键 词：肝硬化 门静脉性肺动脉高压 临床特点 危险因素 

分 类 号：R541[医药卫生—心血管疾病]