摘要
目的 分析肝硬化患者门脉性肺动脉高压(PoPH)的发生率、临床特征及危险因素。方法 收集2021年3月至2022年3月于中国医科大学附属第一医院住院的115例肝硬化门静脉高压患者的一般临床资料、实验室化验及检查结果,根据超声心动图结果是否合并肺动脉高压为标准分为PoPH组和非PoPH组。分析两组患者的一般临床特征及多因素logistic回归分析肝硬化发生PoPH的独立危险因素。结果 (1)肝硬化患者PoPH的发生率为8.7%(10/115)。(2)PoPH组10例,平均年龄(54.5±14.3)岁,平均肺动脉压力(44.0±4.3)mmHg。非PoPH组105例,平均年龄(56.9±10.7)岁。PoPH组患者血红蛋白(Hb)、血清白蛋白(ALB)显著低于非PoPH组(P<0.05);PoPH组平均红细胞容积(MCV)、平均红细胞血红蛋白含量(MCH)、Child-Pugh评分及终末期肝病模型(MELD)评分显著高于非PoPH组(P<0.05)。(3)多因素logistic回归分析结果显示:低Hb(OR 0.95,95%CI 0.90~1.00,P=0.034)是肝硬化门脉高压患者发生肺动脉高压的独立危险因素。结论 本研究肝硬化门脉高压患者中PoPH的发生率为8.7%,Hb和ALB降低以及MCV和MCH升高与肝硬化PoPH的发展密切相关,低Hb是肝硬化门脉高压患者发生肺动脉高压的独立危险因素。
Objective To analyze the prevalence,clinical characteristics and risk factors of portopulmonary hypertension(PoPH)in patients with cirrhosis.Methods Totally 115 cirrhotic patients with portal hypertension who were admitted to the First Affiliated Hospital of China Medical University from March 2021 to March 2022 were selected and were divided into PoPH group and non-PoPH group according to the presence or absence of pulmonary hypertension evaluated by echocardiogram.Clinical data and laboratory tests were collected and analyzed.Multivariate logistic regression analysis was performed to explore the risk factors of cirrhotic PoPH.Results(1)The prevalence of PoPH in cirrhosis was 8.7%(10/115).(2)The average age of 10 patients in PoPH group was 54.5±14.3 years and the average pulmonary hypertension was 44.0±4.3 mmHg.The average age of 105 patients in non-PoPH group was 56.9±10.7 years.Hemoglobin(Hb)and serum albumin(ALB) in PoPH group were significantly lower than that in non-PoPH group(P<0.05).The mean corpuscular volume(MCV),mean corpuscular hemoglobin(MCH),Child-Pugh score and model for end-stage liver disease(MELD)were significantly higher that in non-PoPH group(P<0.05).(3)Multivariate logistic regression analysis demonstrated that low Hb(OR 0.95,95% CI 0.90-1.00,P=0.034)was the independent risk factor for PoPH in cirrhotic patient.Conclusion The prevalence of PoPH in cirrhosis is 8.7%.The decrease in Hb and ALB and the increase in MCV and MCH are closely related to the development of PoPH in patients with cirrhosis.Low Hb is the independent risk factor for PoPH in cirrhotic patient.
作者
黄蝶
张鑫赫
李诗文
王颖
王宁宁
王佳妮
吕晓辉
刘川
李异玲
HUANG Die;ZHANG Xin-he;LI Shi-wen;WANG Ying;WANG Ning-ning;WANG Jia-ni;LYU Xiao-hui;LIU Chuan;LI Yi-ling(Department of Gastroenterology,the First Affiliated Hospital of China Medical University,Shenyang 110001,China;不详)
出处
《中国实用内科杂志》
CAS
CSCD
北大核心
2023年第4期322-326,共5页
Chinese Journal of Practical Internal Medicine
基金
辽宁省教育厅基本科研项目(LJKMZ20221167)。
