Analysis of related factors of pulmonary hypertension in maintenance hemodialysis patients / 中国医师进修杂志

ABSTRACT

ObjectiveTo observe the occurrence and related factors of pulmonary hypertension (PH) in maintenance hemodialysis (MHD) patients.MethodsOne hundred MHD patients were divided into PH group(41 cases) and non-PH group(59 cases) according to the pulmonary artery pressure measured by cardiac ultrasound.The age,systolic blood pressure (SBP),diastolic blood pressure(DBP),vascular access way (arteriovenous fistula,central venous catheter ),dialysis adequacy index (KT/V) and albumin (ALB),hemoglobin (Hb),calcium (Ca),phosphorus (P),parathyroid hormone (PTH) was compared between two groups,and related factors were analyzed by Logistic regression analysis.Results Pulmonary artery systolic pressure (PASP) of PH group and non-PH group was (46.72 ±9.26) mm Hg (1mm Hg =0.133 kPa) and (32.06 ±6.14) mm Hg,and the difference between two groups was significant (P＜ 0.01 ).The arteriovenous fistula rate accounts for 95.1％ (39/41)in PH group,and Hb was (78.27 ±4.53) g/L,PTH was (863.16 ± 146.91 ) ng/L,right ventricular cross diameter was(32.43 ±4.32) mm,right atrial cross diameter was (38.67 ± 7.13 ) mm,right atrial length diameter was (57.23 ± 7.26) mm and left ventricular ejection fraction (LVEF) was (56.38 ± 11.43 )％,while 79.7％ (47/59),(82.67 ± 5.32 ) g/L,(725.68 ± 137.14) ng/L,(21.64 ± 3.65 ) mm,(34.17 ± 6.28) mm,(46.18 ± 6.20) mm,(64.37 ± 6.83)％ in non-PH group,the differences were statisticaly significant between two groups(P ＜0.05 or ＜0.01).Multivariate Logistic regression analysis showed that serum PTH,Hb,rightatrial cross diameter,LVEF,vascular access way were related factors of PH.ConclusionThe serum PTH,Hb,right atrial cross diameter,LVEF,vascular access way are related factors of PH,and the PH may be early prevented and treated by correcting these related factors.