腹膜透析患者肺超声B线形成的影响因素及对预后的影响  

The influencing factors and prognosis value of lung B-line formation examined by ultrasonography inperitoneal dialysis patients

作　　者：吴旭[1] 沈思平 吴炜飞[1] 范德墉[1] 陆敏慧[1] WU Xu;SHEN Si-ping;WU Wei-fei;FAN De-yong;LU Min-hui(Department of Nephrology,Huzhou Central Hospital,Huzhou 313000,China;Section of Ultrasonography,Huzhou Central Hospital,Huzhou 313000,China)

机构地区：[1]湖州市中心医院肾内科,湖州313000 [2]湖州市中心医院B超室,湖州313000

出　　处：《中国血液净化》2023年第11期826-830,共5页Chinese Journal of Blood Purification

基　　金：浙江省医药卫生科技计划项目(2020RC035);湖州市科学技术局公益性应用研究-医卫一般项目(2021GYB58)。

摘　　要：目的探讨肺超声B线在腹膜透析患者中形成的影响因素及对预后的影响。方法选取2018年1月—2020年1月在湖州市中心医院肾内科规律随诊的腹膜透析患者200例,随访至2022年6月30日。根据肺超声B线数量,分为3组,轻度组、中度组和重度组,收集相关资料。结果多元线性回归分析显示:肺超声B线数量与收缩压(β=0.090,P=0.003)、舒张压(β=0.201,P<0.001)、超滤量(β=-0.010,P=0.017)、血红蛋白(β=-0.112,P=0.026)、血脑利钠肽(BNP)(β=0.008,P<0.001)及肺动脉收缩压(β=0.294,P=0.006)相关。多因素COX回归分析显示:B线数量(OR=1.109,95%CI:1.019~1.208,P=0.017)、心功能分级(OR=4.290,95%CI:1.564~11.771,P=0.005)和BNP(OR=1.001,95%CI:1.000~1.002,P=0.003)是腹膜透析患者心血管疾病的独立危险因素。截至随访终点,随访19(15,24)个月。轻度组(n=95)、中度组(n=68)、重度组(n=37)患者总生存期存在差异(χ^(2)=16.384,P<0.001)。结论腹膜透析患者肺超声B线形成受多种因素影响。肺超声B线是腹膜透析患者心血管疾病的独立危险因素,与腹膜透析患者的预后相关。Objective To investigate the influencing factors of lung ultrasound B-line formation and its prognosis value in peritoneal dialysis(PD)patients.Methods A total of 200 PD patients regularly followed up in the Nephrology Department of Huzhou Central Hospital were selected and divided into mild group,moderate group and severe group according to the number of lung ultrasound B-lines.Their relevant data were collected,and they were follow-up for 19(15,24)months.Results Multivariate linear regression showed that the number of lung ultrasound B-lines was correlated with systolic blood pressure(β=0.090,P=0.003),diastolic blood pressure(β=0.201,P<0.001),ultrafiltration volume(β=−0.010,P=0.017),hemoglobin(β=−0.112,P=0.026),blood brain natriuretic peptide(BNP;β=0.008,P<0.001)and pulmonary artery systolic blood pressure(β=0.294,P=0.006).Multivariate Cox regression showed that the number of lung ultrasound B-lines(OR=1.109,95%CI:1.019~1.208,P=0.017),cardiac functional grade(OR=4.290,95%CI:1.564~11.771,P=0.005)and BNP(OR=1.001,95%CI:1.000~1.002,P=0.003)were the independent risk factors for cardiovascular disease in PD patients.Kaplan-Meier survival analysis showed that the median survival periods could not be calculated in mild group(n=95),and were 29 and 21 months in moderate group(n=68)and severe group(n=37)respectively;the overall survival period was different among the three groups(χ^(2)=16.384,P<0.001).Conclusion The formation of lung B-line examined by ultrasonography is influenced by many factors in PD patients.The number of lung ultrasound B-lines is an independent risk factor for cardiovascular disease,and is also associated with the prognosis of PD patients.

关 键 词：腹膜透析 肺超声B线 影响因素 预后 

分 类 号：R459.5[医药卫生—治疗学]