Diagnosis and prognosis of pulmonary hypertension in patients on hemodialysis using spiral CT scanning
10.3760/cma.j.issn.1001-7097.2015.03.005
- VernacularTitle:多层螺旋CT在诊断血液透析患者肺动脉高压中的价值
- Author:
Ziliang WANG
;
Jianyong LIU
;
Yan XU
- Publication Type:Journal Article
- Keywords:
Computed tomography,Spiral;
Hypertension,pulmonary;
Hemodialysis
- From:
Chinese Journal of Nephrology
2015;31(3):179-185
- CountryChina
- Language:Chinese
-
Abstract:
Objective To assess the value of multislice spiral computed tomography (MSCT) in diagnosing pulmonary hypertension.Methods One hundred and forty-two patients on hemodialysis were divided into the group with pulmonary artery hypertension and the group without pulmonary artery hypertension.The diagnosis of pulmonary artery hypertension (pulmonary artery systolic pressure,PASP ＞ 35 mmHg) was according to the guideline from the American Society of Echocardiography.All patients were received the check of MSCT and the diameters of the main pulmonary artery,ascending aorta and descending aorta were recorded.PASP and left ventricular ejection fraction were assessed by echocardiography.High sensitivity C-reactive protein and rumor necrosis factor were measured by automatic analyzer and enzyme linked immunosorbent assay.Results There were significant differences between the two groups in systolic blood pressure,hemoglobin,serum albumin,high sensitivity C-reactive protein and TNF-α (P ＜ 0.05); There were significant differences between the two groups in diameters of the maim pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta (P ＜ 0.05).In different heart function groups,there were significant differences in diameters of the main pulmonary artery,ratio of the diameter of the main pulmonary artery to the diameter of ascending aorta,and ratio of the diameter of the main pulmonary artery to the diameter of descending aorta,and left ventricular ejection fraction (P ＜ 0.05).Ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta was positively related to PASP (r=48.77,P ＜ 0.01),and left ventricular ejection fraction was negatively related to PASP (r=-0.40,P ＜ 0.01).In multivariate linear regression,TNF-α,ratio of the diameter of the maim pulmonary artery to the diameter of ascending aorta and ejection fraction were independent factors of PASP (P ＜ 0.01).Conclusions MSCT measurements play an important role in diagnosis of pulmonary hypertension and in evaluation of clinical prognosis in patients on hemodialysis.
