周润哲, 杨相杰, 孟雨晴, 张定欣, 张瑾, 王盈. 腹膜透析患者液体状态与肺动脉高压的相关性[J]. 临床肾脏病杂志, 2023, 23(7): 529-535. DOI: 10.3969/j.issn.1671-2390.2023.07.001
    引用本文: 周润哲, 杨相杰, 孟雨晴, 张定欣, 张瑾, 王盈. 腹膜透析患者液体状态与肺动脉高压的相关性[J]. 临床肾脏病杂志, 2023, 23(7): 529-535. DOI: 10.3969/j.issn.1671-2390.2023.07.001
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    Zhou Run-zhe, Yang Xiang-jie, Meng Yu-qing, Zhang Ding-xin, Zhang Jin, Wang Ying. Association between fluid status and pulmonary hypertension in peritoneal dialysis patients[J]. Journal of Clinical Nephrology, 2023, 23(7): 529-535. DOI: 10.3969/j.issn.1671-2390.2023.07.001
    Citation: Zhou Run-zhe, Yang Xiang-jie, Meng Yu-qing, Zhang Ding-xin, Zhang Jin, Wang Ying. Association between fluid status and pulmonary hypertension in peritoneal dialysis patients[J]. Journal of Clinical Nephrology, 2023, 23(7): 529-535. DOI: 10.3969/j.issn.1671-2390.2023.07.001
    shu

    腹膜透析患者液体状态与肺动脉高压的相关性

    Association between fluid status and pulmonary hypertension in peritoneal dialysis patients

      摘要
    • 摘要:
      目的  探讨腹膜透析（peritoneal dialysis，PD）患者液体状态与肺动脉高压（pulmonary hypertension，PH）的相关性。
      方法  纳入2020年9月至2022年6月期间在安徽医科大学第一附属医院肾脏内科规律随访的PD患者，收集患者的一般人口学资料、临床资料和实验室指标。采用超声心动图检测患者肺动脉收缩压。采用人体成分分析仪评估患者液体状态，相对水负荷水负荷（over-hydration，OH）/细胞外液量（extracellular water，ECW）比值≥15%诊断为液体超负荷（fluid overload，FO）。采用多因素logistic回归分析PH的危险因素。
      结果  本研究共纳入PD患者102例，PH组36例（35.3%），非PH组66例（64.7%）。PH组的液体状态相关指标（OH、OH/ECW、ECW、总体水）显著高于非PH组，差异有统计学意义（P＜0.05）。多因素logistic回归分析显示，高龄、吸烟和OH/ECW≥15%为PH的独立危险因素。
      结论  FO是PD患者发生PH的独立危险因素，此类患者应及早行PH的超声心动图筛查，并积极纠正FO状态预防PH的发生。

       

      Abstract:
      Objective  To explore the correlation between fluid status and pulmonary hypertension (PH) in peritoneal dialysis (PD) patients.
      Methods  From September 2020 to June 2022, 102 PD patients were recruited and followed up regularly. General demographics, clinical data and laboratory indicators were collected. Pulmonary arterial systolic pressure was measured by echocardiography. Fluid status was evaluated by a body composition analyzer. The relative over hydration over hydration (OH)/extracellular water (ECW) ≥15% was diagnosed as fluid overload (FO). Multivariate Logistic regression was utilized for examining the risk factors of PH.
      Results  Among them, there were 36 PH (35.3%) and 66 non-PH patients (64.7%). The relevant indicators of fluid state OH, OH/ECW, ECW, total body water (TBW) were significantly higher in PH group than those in non-PH group and the differences were statistically significant (P＜0.05). Multivariate Logistic regression analysis indicated that advanced age, smoking and OH/ECW≥15% were independent risk factors for PH.
      Conclusions  FO is an independent risk factor for the occurrence of PH in PD patients. And PD patients with FO should be screened for PH by echocardiography and the status of FO corrected aggressively as soon as possible to prevent PH.

       

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