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目的:探讨肺高压合并心包积液对维持性血液透析(MHD)患者预后的影响。方法 :入组2009-2011年108例合并肺高压的MHD患者(其中61例伴有心包积液),随访2年,采用生存曲线分析终点事件(全因死亡、心血管死亡和新发心血管事件)。结果:患者平均初始透析年龄为(60.2±14.1)岁,男性占55.6%,平均肺动脉压力为(53.0±15.4)mm Hg。12.0%为重度肺高压,2例(1.9%)为中至大量心包积液。随访2年,心包积液组和无心包积液组全因死亡、心血管死亡和新发心血管事件发生率分别为34.4%vs.21.3%、23.0%vs.12.8%和54.1%vs.42.6%(均P>0.05)。生存分析显示两组在全因死亡率(Log Rank P=0.129)、心血管死亡(P=0.148)和新发心血管事件(P=0.131)方面均无差异。结论 :与不伴心包积液的患者相比,合并心包积液的肺高压患者并不增加MHD患者终点事件。
Objective: To investigate the effect of pulmonary hypertension combined with pericardial effusion on the prognosis of maintenance hemodialysis (MHD) patients. METHODS: A total of 108 MHD patients with pulmonary hypertension (61 with pericardial effusion) from 2009 to 2011 were enrolled in the study. Survival curves were used to analyze the endpoint events (all-cause death, cardiovascular death, and new-onset cardiovascular disease event). RESULTS: The mean initial dialysis age was (60.2 ± 14.1) years, with 55.6% in men and 53.0 ± 15.4 mm Hg in mean pulmonary artery pressure. 12.0% were severe pulmonary hypertension, and 2 cases (1.9%) were moderate to large pericardial effusion. After 2 years of follow-up, the rates of all-cause death, cardiovascular death and new cardiovascular events in pericardial effusion group and non-pericardial effusion group were 34.4% vs.21.3%, 23.0% vs.12.8% and 54.1% vs.42.6 % (All P> 0.05). Survival analysis showed no difference in all-cause mortality (Log Rank P = 0.129), cardiovascular death (P = 0.148), and new cardiovascular events (P = 0.131). CONCLUSIONS: Patients with pulmonary hypertension with pericardial effusion did not increase endpoint events in MHD patients compared with patients without pericardial effusion.