肺动脉高压在慢性肾脏病中的研究进展
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摘要
肺动脉高压是以肺动脉压和肺血管阻力升高为特征的进行性疾病,最终导致右心功能衰竭,是慢性肾脏病患者的常见并发症。合并肺动脉高压的慢性肾脏病患者住院和死亡风险增加,是长期生存的重要预测指标。肺动脉高压在慢性肾脏病中的发病机制复杂,目前仍不十分清楚。临床上应早期识别并给予积极治疗。本文就慢性肾脏病患者肺动脉高压的研究进展作一综述。
Pulmonary hypertension is a progressive disease characterized by elevated blood pressure and vascular resistance in pulmonary arteries finally leading to right heart failure. It is a common complication in chronic kidney disease(CKD) patients. CKD patients with pulmonary hypertension have higher risk of hospitalization and death. Therefore, pulmonary hypertension is a unfavorable predictor for survival in CKD patients. The pathogenesis of pulmonary hypertension in CKD patients is complicated and remains elusive. Early identification and active treatment are clinically essential. This article reviews the research progresses in pulmonary hypertension in CKD patients.
Pulmonary hypertension is a progressive disease characterized by elevated blood pressure and vascular resistance in pulmonary arteries finally leading to right heart failure. It is a common complication in chronic kidney disease(CKD) patients. CKD patients with pulmonary hypertension have higher risk of hospitalization and death. Therefore, pulmonary hypertension is a unfavorable predictor for survival in CKD patients. The pathogenesis of pulmonary hypertension in CKD patients is complicated and remains elusive. Early identification and active treatment are clinically essential. This article reviews the research progresses in pulmonary hypertension in CKD patients.
引文
[1]Navaneethan SD,Roy J,Tao K,et al.Prevalence,predictors,and outcomes of pulmonary hypertension in CKD[J].J Am Soc Nephrol,2016,27(3):877-886.
[2]Tang M,Batty JA,Lin C,et al.Pulmonary Hypertension,Mortality,and Cardiovascular Disease in CKD and ESRD Patients:A Systematic Review and Meta-analysis.[J].American Journal of Kidney Diseases,2018,72(1):75-83.
[3]Shang W,Li Y,Ren Y,et al.Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis:a meta-analysis[J].International Urology and Nephrology,2018,50(8):1497-1504.
[4]Zeng Y,Yang DD,Feng S,et al.Risk factors for pulmonary hypertension in patients receiving maintenance peritoneal dialysis[J].Braz J Med Biol Res,2016,49(3):e4733.
[5]姚春萌,周礼平.郭汉城腹膜透析患者发生肺动脉高压危险因素分析[J].中国血液净化,2017,16(4):234-237.
[6]Zhang Q,Wang L,Zeng H,et al.Epidemiology and risk factors in CKD patients with plmonary hypertension:a retrospective study[J].Bmc Nephrology,2018,19(1):70-77.
[7]Zhilian Li,Xinling Liang,Shuangxin Liu,et al.Pulmonary Hypertension:Epidemiology in Different CKD Stages and Its Association with Cardiovascular Morbidity[J].Plos One,2014,9(12):e114392.
[8]Pabst S,Hammerstingl C,Hundt F,et al.Pulmonary hypertension in patients with chronic kidney disease on dialysis and without dialysis:results of the PEPPER-study[J].PLoS One,2012,7(4):e35310.
[9]Ramasubbu K,Deswal A,Herdejurgen C,et al.A prospective echocardiographic evaluation of pulmonary hypertensionin chronic hemodialysis patients inthe United States:prevalence and clinical significance[J].Int JGen Med,2010,3(3):279-286.
[10]Suresh H,Arun BS,Moger V,et al.A Prospective Study of Pulmonary Hypertension in Patients with Chronic Kidney Disease:A New and Pernicious Complication[J].Indian Journal of Nephrology,2018,28(2):127-134.
[11]Dhaun N,Goddard J,Webb DJ.The endothelin system and its antagonism in chronic kidney disease[J].J Am Soc Nephrol,2006,17(4):943-955.
[12]Ward JP,McMurtry IF.Mechanisms of hypoxic pulmonary vasoconstriction and their roles in pulmonary hypertension:new findings for an old problem[J].Curr Opin Pharmacol,2009,9(3):287-296.
[13]BarcelóA,de la Pe?a M,Ayllón O,et al.Increased plasma levels of asymmetric dimethylarginine and soluble CD40 ligand inpatients with sleep apnea[J].Respiration,2009,77(1):85-90.
[14]Hammerstingl C,Schueler R,Bors L,et al.Diagnostic value of echocardiography in the diagnosis of pulmonary hypertension[J].PLoS One,2012,7(6):e38519.
[15]Janda S,Shahidi N,Gin K,et al.Diagnostic accuracy of echocardiography for pulmonary hypertension:a systematic review and meta-analysis[J].Heart,2011,97(8):612-622.
[16]Liefeldt L,Giersbergen PV.Treatment of secondary pulmonary hypertension with bosentan and its pharmacokinetic monitoring in ESRD[J].American Journal of Kidney Diseases,2004,43(5):923-926.
[17]Dhaun N,MacIntyre IM,Kerr D et al.Selective endothelin-A receptor antagonism reduces proteinuria,blood pressure,and arterial stiffness in chronic proteinuric kidney disease[J].Hypertension,2011,57(4):772-779.
[18]Dasgupta A,Bowman L,D'Arsigny CL,et al.Soluble guanylate cyclase:a new therapeutic target for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension[J].Clin Pharmacol Ther,2015,97(1):88-102.
[19]Sise ME,Courtwright AM,Channick RN.Pulmonary hypertension in patients with chronic and end-stage kidney disease[J].Kidney International,2013,84(4):682-692.
[20]Sompradeekul S,Wattanasiriphakdee S.Hemodynamic effect of iloprost inhalation and oral sildenfil during acute vasoreactivity test in pulmonary arterial hypertension[J].J Med Assoc Thai,2015,98(2):144-149.··
[2]Tang M,Batty JA,Lin C,et al.Pulmonary Hypertension,Mortality,and Cardiovascular Disease in CKD and ESRD Patients:A Systematic Review and Meta-analysis.[J].American Journal of Kidney Diseases,2018,72(1):75-83.
[3]Shang W,Li Y,Ren Y,et al.Prevalence of pulmonary hypertension in patients with chronic kidney disease without dialysis:a meta-analysis[J].International Urology and Nephrology,2018,50(8):1497-1504.
[4]Zeng Y,Yang DD,Feng S,et al.Risk factors for pulmonary hypertension in patients receiving maintenance peritoneal dialysis[J].Braz J Med Biol Res,2016,49(3):e4733.
[5]姚春萌,周礼平.郭汉城腹膜透析患者发生肺动脉高压危险因素分析[J].中国血液净化,2017,16(4):234-237.
[6]Zhang Q,Wang L,Zeng H,et al.Epidemiology and risk factors in CKD patients with plmonary hypertension:a retrospective study[J].Bmc Nephrology,2018,19(1):70-77.
[7]Zhilian Li,Xinling Liang,Shuangxin Liu,et al.Pulmonary Hypertension:Epidemiology in Different CKD Stages and Its Association with Cardiovascular Morbidity[J].Plos One,2014,9(12):e114392.
[8]Pabst S,Hammerstingl C,Hundt F,et al.Pulmonary hypertension in patients with chronic kidney disease on dialysis and without dialysis:results of the PEPPER-study[J].PLoS One,2012,7(4):e35310.
[9]Ramasubbu K,Deswal A,Herdejurgen C,et al.A prospective echocardiographic evaluation of pulmonary hypertensionin chronic hemodialysis patients inthe United States:prevalence and clinical significance[J].Int JGen Med,2010,3(3):279-286.
[10]Suresh H,Arun BS,Moger V,et al.A Prospective Study of Pulmonary Hypertension in Patients with Chronic Kidney Disease:A New and Pernicious Complication[J].Indian Journal of Nephrology,2018,28(2):127-134.
[11]Dhaun N,Goddard J,Webb DJ.The endothelin system and its antagonism in chronic kidney disease[J].J Am Soc Nephrol,2006,17(4):943-955.
[12]Ward JP,McMurtry IF.Mechanisms of hypoxic pulmonary vasoconstriction and their roles in pulmonary hypertension:new findings for an old problem[J].Curr Opin Pharmacol,2009,9(3):287-296.
[13]BarcelóA,de la Pe?a M,Ayllón O,et al.Increased plasma levels of asymmetric dimethylarginine and soluble CD40 ligand inpatients with sleep apnea[J].Respiration,2009,77(1):85-90.
[14]Hammerstingl C,Schueler R,Bors L,et al.Diagnostic value of echocardiography in the diagnosis of pulmonary hypertension[J].PLoS One,2012,7(6):e38519.
[15]Janda S,Shahidi N,Gin K,et al.Diagnostic accuracy of echocardiography for pulmonary hypertension:a systematic review and meta-analysis[J].Heart,2011,97(8):612-622.
[16]Liefeldt L,Giersbergen PV.Treatment of secondary pulmonary hypertension with bosentan and its pharmacokinetic monitoring in ESRD[J].American Journal of Kidney Diseases,2004,43(5):923-926.
[17]Dhaun N,MacIntyre IM,Kerr D et al.Selective endothelin-A receptor antagonism reduces proteinuria,blood pressure,and arterial stiffness in chronic proteinuric kidney disease[J].Hypertension,2011,57(4):772-779.
[18]Dasgupta A,Bowman L,D'Arsigny CL,et al.Soluble guanylate cyclase:a new therapeutic target for pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension[J].Clin Pharmacol Ther,2015,97(1):88-102.
[19]Sise ME,Courtwright AM,Channick RN.Pulmonary hypertension in patients with chronic and end-stage kidney disease[J].Kidney International,2013,84(4):682-692.
[20]Sompradeekul S,Wattanasiriphakdee S.Hemodynamic effect of iloprost inhalation and oral sildenfil during acute vasoreactivity test in pulmonary arterial hypertension[J].J Med Assoc Thai,2015,98(2):144-149.··