Related Factors Of Pulmonary Artery Hypertension In Maintenance Hemodialysis Patients

Objective:The purpose of this study is to discuss the clinical features of pulmonary artery hypertension in maintenance hemodialysis patients, analyse its risk factors, and contribute to early diagnosis and intervention.Methods:We surveyed the maintenance hemodialysis patients in the fifth affiliated hospital of zhengzhou university blood purification center from June 2015 to December 2015. 128 maintenance hemodialysis patients were selected in this study.We collected the clinical datas, such as general condition, dialysis data, laboratory indexes, echocardiography results and so on. According to the pulmonary arterial systolic pressure, the patients were divided into pulmonary artery hypertension group(PAH group) and control group(n PAH group). And compared the clinical datas of two groups to find whether there was a statistically significance by using t test and chi-square test. Multivariate Logistic regression analysis was applied to analyse the related factors of pulmonary hypertension in hemodialysis patients.Results:There were 36 pulmonary hypertension artery patients in 128 hemodialysis patients, the incidence of pulmonary artery hypertension is 28.1%. By compared the clinical dates of PAH group and n PAH group, we found there were no statistically significance in gender, age, dialysis age, systolic pressure, diastolic blood pressure,the primary disease, vascular access, urea clearance index(Kt/V), urea nitrogen rate drop(URR), albumin(Alb), prealbumin(PA), total protein(TP), ferritin(Ferr), total cholesterol(TC), triglyceride(TG), calcium(Ca), phosphorus(P),calcium-phosphorus product(Ca×P), intact parathyroid hormone(i PTH), left ventricular posterior wall thickness(LVPWT), inter-ventricular septum end-diastolic thickness(IVSTd), left ventricular ejection fraction(LVEF), cardiac output(CO),left ventricular short axis reduced rate(FS) and degree of heart valve calcification. There were statistically significance in the increased weight of intervals between two times of hemodialysis, the ratio of the increased weight to target weight, hemoglobin(Hb),B-type natriuretic peptide(BNP), high sensitivity C-reactive protein(hs CRP), insulin resistance(IR), left atrial diameter(LAD), left ventricular end systolic dimension(LVIDs), left ventricular end diastolic dimension(LVIDd), ratio of early diastolic filling to atrial filling velocity mitral flow. Multivariate Logistic regression analysis showed that BNP, hs-CRP, IR, Hb, LAD, E/A, ratio of the increased weight to target weight are risk factors for pulmonary artery hypertension of hemodialysis patients.Conclusions:1, The incidence of pulmonary artery hypertension is high in the maintenance hemodialysis patients. The prognosis of pulmonary hypertension patients are disappointing, therefore need to prevent and treat actively. 2, BNP,hs-CRP, IR, LAD, ratio of the increased weight to target weight may be involved in the occurrence and development of pulmonary artery hypertension. Hb, E/A are the protected factors of PAH in MHD patients.