血红蛋白变异度与慢性肾脏病5期透析患者并发肺动脉高压的关系  

Relationship between hemoglobin variability and pulmonary arterial hypertension in patients with chronic kidney disease undergoing phase 5 dialysis

作　　者：王念华[1] 吴玉彩[1] WANG Nian-hua;WU Yu-cai(Department of Nephrology,Puyang Peoples Hospital,Puyang,Henan 457000,China)

机构地区：[1]濮阳市人民医院肾内科,河南濮阳457000

出　　处：《医药论坛杂志》2024年第9期928-932,共5页Journal of Medical Forum

摘　　要：目的探讨血红蛋白(Hb)变异度与慢性肾脏病(chronic kidney disease,CKD)5期透析患者并发肺动脉高压(pulmonary arterial hypertension,PAH)的关系。方法回顾性分析2021年1月—2023年4月濮阳市人民医院97例CKD 5期透析患者的临床资料,根据肺动脉平均压水平将其分为PAH组(n=43)和non-PAH组(n=54)。于患者透析期间多次检测Hb水平,计算Hb变异度。采用二元logistic回归分析CKD 5期透析患者并发PAH的危险因素,绘制受试者工作特征(ROC)曲线分析Hb变异度对CKD 5期透析患者并发PAH的预测价值。结果PAH组透析龄高于non-PAH组,左心房内径大于non-PAH组,差异有统计学意义(P<0.05)。PAH组和non-PAH组患者在Hb剩余标准差、Hb变异度6组占比方面比较,差异有统计学意义(P<0.05)。经二元logistic回归分析,透析龄、Hb变异度是CKD 5期透析患者并发PAH的危险因素(OR>1,P<0.05)。绘制ROC曲线,Hb变异度对CKD 5期透析患者并发PAH具有一定预测价值(AUC=0.801,P<0.001)。结论Hb变异度与CKD 5期透析患者并发PAH有关,可作为预测CKD 5期透析患者并发PAH的指标。Objective To investigate the relationship between hemoglobin(Hb)variability and pulmonary arterial hypertension(PAH)in patients with chronic kidney disease(CKD)undergoing phase 5 dialysis.Methods A retrospective analysis was conducted on the clinical data of 97 CKD stage 5 dialysis patients in hospitals from January 2021 to April 2023.They were divided into PAH group(n=43)and non-PAH group(n=54)based on the average pulmonary artery pressure levels.Hb levels were measured multiple times during dialysis,and Hb variability was calculated.Binary logistic regression was used to analyze the risk factors of PAH in patients with CKD stage 5 dialysis,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of Hb variability for PAH in patients with CKD stage 5 dialysis.Results The dialysis age of PAH group was higher than that of non-PAH group,and the left atrial diameter was larger than that of non-PAH group,with a statistical significant difference(P<0.05).There was a statistical significant difference in the proportion of Hb residual standard deviation and Hb variability between the PAH group and the non-PAH group(P<0.05).According to binary logistic regression analysis,dialysis age and Hb variability were risk factors for PAH in CKD stage 5 dialysis patients(OR>1,P<0.05).The Receiver operating characteristic and Hb variability had a certain predictive value for CKD 5 dialysis patients complicated with PAH(AUC=0.801,P<0.001).Conclusion Hb variability is related to the occurrence of PAH in CKD stage 5 dialysis patients,and can be used as a predictor of PAH in CKD stage 5 dialysis patients.

关 键 词：慢性肾脏病 血红蛋白变异度 血液透析 肺动脉高压 

分 类 号：R692[医药卫生—泌尿科学]