慢性肾脏病患者肺动脉高压患病率及其与临床生化指标相关性的研究

Dr.Neelam Redkar
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摘要

-目的:本前瞻性观察性研究的目的是研究(i)肺高压(PH)在保守治疗、血液透析或连续动态腹膜透析患者中的患病率,(ii) PH与A-V瘘、高血压、糖尿病和透析时间等变量的相关关系,以及(iii) PH与生化参数的相关关系。材料和方法:该研究在获得机构伦理委员会批准后,在孟买的一家三级保健中心进行了为期12个月的研究。245名CKD患者,接受保守治疗,血液透析和持续的门诊腹膜透析,纳入了本研究,在获得每位患者的详细病史后,考虑了纳入和排除标准以及适当的知情同意。所有患者均行常规检查和二维超声检查肺动脉高压。结果:我们的研究纳入了245例患者,年龄在20至85岁之间,其中68.6%为男性,31.4%为女性。28.2%的患者为CKD合并PH, 71.8%的患者为CKD不合并PH。有PH的患者合并房室瘘的比例明显高于无房室瘘的患者。在28.2%的PH患者中,33.6%患有高血压,22%患有糖尿病。我们的研究揭示了透析时间与PH患病率、低血红蛋白和血清碳酸氢盐水平、高尿酸、BUN和肌酐水平之间的正相关。结论:PH患病率为28.2%。PH值与化学和生化参数呈正相关。
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Study Of Prevalence Of Pulmonary Hypertension In Chronic Kidney Disease And Its Co-Relation With Clinical & Biochemical Parameters.
-OBJECTIVES: The objectives of this prospective observational study were to study (i) the prevalence of pulmonary hypertension (PH) in patients who are on conservative management, haemodialysis or continuous ambulatory peritoneal dialysis, (ii) the co-relation of PH with variables such as A-V fistula, hypertension, diabetes Mellitus & duration for dialysis, and (iii) the co-relation of PH with biochemical parameters.MATERIALS AND METHODS: The study was conducted in a tertiary care centre in Mumbai over a period 12 months after obtaining approval from the Institutional Ethics Committee. 245 CKD patients, on conservative management, haemodialysis and continuous ambulatory peritoneal dialysis were enrolled in this study, taking into consideration the inclusion & exclusion criteria and appropriate informed consent after taking detailed history of every patient. All patients underwent routine investigations and 2D ECHO for pulmonary hypertension. RESULTS: Our study enrolled 245 patients in the age group of 20 to 85 years where 68.6% patients were male and 31.4% were females. 28.2% patients had CKD with PH while 71.8% had CKD without PH. The proportion of patients with PH having AV fistula was significantly more than those without AV fistula. Of the 28.2% patients with PH, 33.6% had hypertension and 22% were diabetic. Our study revealed a positive association between the duration of dialysis and the prevalence of PH along-with low levels of haemoglobin and serum bicarbonate, and high levels of uric acid, BUN and creatinine. CONCLUSION: The prevalence of PH was found to be 28.2%. PH is positively correlated with chemical as well as biochemical parameters.
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