腹膜透析患者液体状态与肺动脉高压的相关性  

Association between fluid status and pulmonary hypertension in peritoneal dialysis patients

作　　者：周润哲 杨相杰 孟雨晴 张定欣 张瑾[3] 王盈 Zhou Run-zhe;Yang Xiang-jie;Meng Yu-qing;Zhang Ding-xin;Zhang Jin;Wang Ying(Department of Epidemiology and Health Statistics,School of Public Health,Anhui Medical University,Hefei 230032,China;Department of Cardiac Imaging Center,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Nephropathy,First Affiliated Hospital of Anhui Medical University,Hefei 230022,China)

机构地区：[1]安徽医科大学公共卫生学院流行病与卫生统计学系,合肥230032 [2]安徽医科大学第一附属医院心脏影像中心,合肥230022 [3]安徽医科大学第一附属医院肾脏内科,合肥230022

出　　处：《临床肾脏病杂志》2023年第7期529-535,共7页Journal Of Clinical Nephrology

基　　金：国家自然科学基金青年项目(82200833);安徽医科大学第一附属医院博士后科研基金(1458);安徽医科大学校科研基金项目(2019xkj011)。

摘　　要：目的探讨腹膜透析(peritoneal dialysis,PD)患者液体状态与肺动脉高压(pulmonary hypertension,PH)的相关性。方法纳入2020年9月至2022年6月期间在安徽医科大学第一附属医院肾脏内科规律随访的PD患者,收集患者的一般人口学资料、临床资料和实验室指标。采用超声心动图检测患者肺动脉收缩压。采用人体成分分析仪评估患者液体状态,相对水负荷[水负荷(over-hydration,OH)/细胞外液量(extracellular water,ECW)比值]≥15%诊断为液体超负荷(fluid overload,FO)。采用多因素logistic回归分析PH的危险因素。结果本研究共纳入PD患者102例,PH组36例(35.3%),非PH组66例(64.7%)。PH组的液体状态相关指标(OH、OH/ECW、ECW、总体水)显著高于非PH组,差异有统计学意义(P<0.05)。多因素logistic回归分析显示,高龄、吸烟和OH/ECW≥15%为PH的独立危险因素。结论FO是PD患者发生PH的独立危险因素,此类患者应及早行PH的超声心动图筛查,并积极纠正FO状态预防PH的发生。Objective To explore the correlation between fluid status and pulmonary hypertension(PH)in peritoneal dialysis(PD)patients.Methods From September 2020 to June 2022,102 PD patients were recruited and followed up regularly.General demographics,clinical data and laboratory indicators were collected.Pulmonary arterial systolic pressure was measured by echocardiography.Fluid status was evaluated by a body composition analyzer.The relative over hydration[over hydration(OH)/extracellular water(ECW)]≥15%was diagnosed as fluid overload(FO).Multivariate Logistic regression was utilized for examining the risk factors of PH.Results Among them,there were 36 PH(35.3%)and 66 nonPH patients(64.7%).The relevant indicators of fluid state[OH,OH/ECW,ECW,total body water(TBW)]were significantly higher in PH group than those in non-PH group and the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis indicated that advanced age,smoking and OH/ECW≥15%were independent risk factors for PH.Conclusions FO is an independent risk factor for the occurrence of PH in PD patients.And PD patients with FO should be screened for PH by echocardiography and the status of FO corrected aggressively as soon as possible to prevent PH.

关 键 词：腹膜透析 肺动脉高压 超声心动图 成分分析 

分 类 号：R692.5[医药卫生—泌尿科学] R544.1[医药卫生—外科学]