超声心动图对尿毒症血透患者并发肺动脉高压临床研究.docVIP

超声心动图对尿毒症血透患者并发肺动脉高压临床研究 　　【摘要】 目的 研究??用超声心动图诊断尿毒症血液透析（血透）患者并发肺动脉高压的临床效果。方法 80例尿毒症实施血液透析患者作为研究对象， 应用超声心动图对患者的肺动脉压进行评估， 将存在肺动脉高压患者定义为观察组， 未出现肺动脉高压患者定义为对照组。比较两组患者的一般资料及超声心动图检测结果。结果 80例患者中， 肺动脉高压17例、占患者总数的21.25%（观察组）， 正常肺动脉压63例、占患者总数的78.75%（对照组）。两组患者的年龄、性别对比， 差异均无统计学意义（t=0.0712， χ2=0.0085， P0.05）；观察组患者透析时间长于对照组， 收缩压及舒张压均高于对照组， 差异均具有统计学意义（t=2.3238、2.0205、2.1278， P0.05）；观察组患者的收缩期肺动脉压显著高于对照组， 差异具有统计学意义（t=10.6885， P0.05）。结论 尿毒症血液透析患者仅少部分存在肺动脉高压情况， 患者的心输出量、每搏输出量、左心室射血分数等超声心动图检测指标与收缩期肺动脉压增高无明显的关系， 故尿毒症血液透析患者并发肺动脉高压的影响因素还有待临床实验去发现研究。 　　【关键词】 超声心动图；血液透析；尿毒症；肺动脉高压 　　【Abstract】 Objective To study the clinical effect of ultrasonic cardiogram in the diagnosis of pulmonary arterial hypertension in uremia hemodialysis patients. Methods A total of 80 uremia patients with hemodialysis as study subjects. Their pulmonary artery pressure were all evaluated by ultrasonic cardiogram， and patients with pulmonary arterial hypertension as observation group， patients without pulmonary arterial hypertension as control group. Comparison were made on general data and ultrasonic cardiogram test results in two groups. Results Among 80 patients， there were 17 pulmonary arterial hypertension cases， accounting for 21.25% （observation group）， 63 normal pulmonary artery pressure cases， accounting for 78.75% （control group）. Both groups had no statistically significant difference in age and gender （t=0.0712， χ2=0.0085， P0.05）. The observation group had longer hemodialysis time than the control group， and higher systolic blood pressure and diastolic blood pressure than the control group. All their differences had statistical significance （t=2.3238， 2.0205， 2.1278， P0.05）. The observation group had obviously higher systole pulmonary artery pressure than the control group， and the difference had statistical significance （t=10.6885， P 　　【Key words】 Ultrasonic cardiogram； Hemodialysis； Uremia； Pulmonary arterial hypertension 　　有报道指出[1]， 肺动脉高压属于临床难治性病症之一， 随着近年来我国尿毒症患者的增多， 患者需要长期进行维持性血液透析治疗， 导致临床上尿毒症合并肺动脉