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目的探讨经自体动静脉内瘘(AVF)维持性血液透析(maintenance hemodialysis,MHD)患者发生肺动脉高压(pulmonary atery hypertention,PAH)的相关危险因素。方法选取我院2011年1月至2013年1月MHD患者82例,采用多普勒超声心动图检测患者的肺动脉压力、心脏结构和功能,收集同期临床资料及实验室检查结果,根据有无PAH分为PAH组和无PAH组,进行统计学分析。结果 36例患者存在PAH,发生率43.90%,其中轻度24例(66.67%),中度11例(30.56%),重度1例(2.77%)。PAH组年龄、LAD、IVSTd、LVPWT、LVH、LVMI、二尖瓣反流、三尖瓣反流发生率均高于无PAH组(P<0.05或P<0.01)。Logistic回归分析表明,LAD、LVPWT、LVMI、二尖瓣反流、三尖瓣反流与是PAH的主要相关因素。结论 MHD患者并发PAH并不少见,心脏结构改变及瓣膜反流在PAH发生可能起重要作用。
Objective To investigate the related risk factors of pulmonary atery hypertrophy (PAH) in patients with autistic arteriovenous fistula (AVF) maintenance hemodialysis (MHD). Methods Eighty-two MHD patients from January 2011 to January 2013 in our hospital were selected. Pulmonary arterial pressure, cardiac structure and function were measured by Doppler echocardiography. The clinical data and laboratory findings were collected at the same period. According to the presence or absence of PAH Divided into PAH group and no PAH group, for statistical analysis. Results Thirty-six patients had PAH. The incidence rate was 43.90%. Among them, 24 were mild (66.67%), 11 were moderate (30.56%) and 1 was severe (2.77%). The PAH group had higher incidence of LAD, IVSTd, LVPWT, LVH, LVMI, mitral regurgitation and tricuspid regurgitation than those without PAH (P <0.05 or P <0.01). Logistic regression analysis showed that LAD, LVPWT, LVMI, mitral regurgitation, tricuspid regurgitation and PAH were the main relevant factors. Conclusion It is not uncommon for patients with MHD complicated with PAH. Changes in cardiac structure and valvular regurgitation may play an important role in the pathogenesis of PAH.