Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
Pulmonary hypertension: epidemiology in different CKD stages and its association with cardiovascular morbidity.
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肺动脉高压：不同 CKD 阶段的流行病学及其与心血管发病率的关系。
DOI：
10.1371/journal.pone.0114392
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发表时间：
2014
期刊：
影响因子：
3.7
通讯作者：
Shi W
中科院分区：
文献类型：
--
作者：
Li Z;Liang X;Liu S;Ye Z;Chen Y;Wang W;Li R;Xu L;Feng Z;Shi W
肺动脉高压(PH)是终末期肾病(ESRD)的一种常见并发症，可增加死亡风险。关于慢性肾脏疾病(CKD)早期阶段的这种疾病及其与心血管(CV)发病率的相关性的流行病学数据很少。我们回顾分析了2008年1月至2012年5月期间2351例具有完整临床记录和超声心动图数据的CKD患者。将患者分为6组：CKD期1~4，未透析或开始透析3个月的5期，≥3个月的5D期。通过Logistic回归模型对PH和心血管疾病的患病率进行了调查，并对两者之间的相关性进行了评估。426例(18.1%)患者出现PH值。轻度PH占12.1%，中度PH占4.9%，重度PH占1.1%。CKD 5期和5D期均出现重度PH。心血管并发症645例(27.4%)。与非PH组相比，PH组患心脏病的风险较高，但患脑血管疾病的风险不高。PH严重程度与心脏并发症风险相关[轻度PH的优势比(95%CI)：1.79(1.30~2.47)；中度PH：2.75(1.73~4.37)；重度PH：3.90(1.46~10.42)]。我们的研究首次显示了慢性肾脏病各病种的PH流行病学概况。轻、中度PH在晚期CKD中发生率较高，在非终末期CKD中重度PH较少。CKD中的PH与心脏疾病有关，但与脑血管疾病无关，心脏发病率随着PH严重程度的增加而增加。需要来自前瞻性研究的证据来预测这一人群的PH，以预测心脏事件。
Pulmonary hypertension (PH) was recently recognized as a common complication of end-stage renal disease (ESRD) that causes an increased risk of mortality. Epidemiological data for this disorder in earlier stages of chronic kidney disease (CKD) and its association with cardiovascular (CV) morbidity are scarce. We retrospectively analyzed 2,351 Chinese CKD patients with complete clinical records and echocardiography data between Jan 2008 and May 2012. The patients were divided into the following 6 groups: CKD Stages 1–4; Stage 5 for those not on or initiated on hemodialysis for <3 months; and Stage 5D for the patients undergoing hemodialysis for ≥3 months. The prevalence of PH and CV morbidity was investigated, and their association was evaluated with a logistic regression model. PH was detected in 426 patients (18.1%). Mild, moderate and severe PH was diagnosed in 12.1%, 4.9% and 1.1% of the patients, respectively. Severe PH was detected in CKD Stages 5 and 5D. CV morbidity was found in 645 patients (27.4%). Compared with the non-PH group, the PH group had a higher risk for cardiac disease but not for cerebrovascular disease risk. PH severity was associated with cardiac morbidity risk [odds ratio (95% CI) for mild PH: 1.79 (1.30–2.47); moderate PH: 2.75 (1.73–4.37); severe PH: 3.90 (1.46–10.42)]. Our study showed for the first time the epidemiology profile of PH across the spectrum of CKD. Mild-to-moderate PH occurs with more frequency in advanced CKD, and severe PH is scarce in non-ESRD CKD. PH in CKD is associated with cardiac but not cerebrovascular disease, with increasing cardiac morbidity seen with increasing PH severity. Evidence from prospective studies addressing PH in this population is needed to predict cardiac events.
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肺动脉高压作为血液透析患者心血管死亡率和事件的独立预测因子
影响因子：
2
作者：
Li, Zhilian;Liu, Shuangxin;Shi, Wei
通讯作者：
Shi, Wei
DOI：
10.1016/s0735-1097(85)80172-8
发表时间：
1985-01-01
影响因子：
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作者：
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影响因子：
39.3
作者：
McMurray, John J. V.;Adamopoulos, Stamatis;Ponikowski, Piotr
通讯作者：
Ponikowski, Piotr
影响因子：
6.2
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Cosio, Fernando G.