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[Risk factors and impacts on prognosis of ultrasound lung comets in patients undergoing hemodialysis].
Wang, Z L; Liu, J Y; Zhou, C J; Wang, M B; Wang, H Y; Xu, Y.
Afiliação
  • Wang ZL; Department of Nephrology, Laiwu Municipal People's Hospital, Laiwu 271100, China.
Zhonghua Yi Xue Za Zhi ; 97(48): 3796-3801, 2017 Dec 26.
Article em Zh | MEDLINE | ID: mdl-29325339
ABSTRACT

Objective:

To investigate the risk factors of ultrasound lung comets and its impact on the survivals of patients undergoing hemodialysis.

Methods:

One hundred and forty-two patients on hemodialysis (Male 76, female 66) were divided into three groups according to the score of lung comets (mild ≤14 comets; moderate 15 to 30 comets; severe >30 comets). Seventy-two healthy subjects examined by lung ultrasound serve as a control. Pulmonary artery systolic pressure and left ventricular ejection fraction (LVEF) were assessed by Doppler ultrasonography. High-sensitivity C-reactive protein (hsCRP) and tumor necrosis factor (TNF)-α were measured by the automatic analyzer and enzyme-linked immunosorbent assay.

Results:

With the increasing age of the patients, lung comets scores increased (P<0.05). There were significant differences in TNF-α (P<0.05), interdialytic weight gain (IDWG) (P<0.05), pulmonary artery systolic pressure and LVEF (P<0.05) among three groups. In multivariate linear regression, the lung comets score was positively related to multiple clinical variables including New York Heart Association (NYHA) classification (P=0.023), hsCRP (P=0.042), TNF-α (P<0.001), IDWG (P=0.031), and pulmonary artery systolic pressure (P<0.001). In the multivariate Cox proportional hazards models, lung comets score was independent risk factor for death (P=0.001). In Kaplan-Meier survival analysis, the risk of all-cause mortality increased in parallel with lung comets score, and patients with lung comets score (>30 comets) were at highest risk of death among all three groups (log-rank test χ(2)=12.73, P=0.001).

Conclusion:

Lung comets is associated with inflammation, pulmonary artery systolic pressure/volume overload and heart function. Lung comets score represents the alterations of heart function and it may serve as a powerful predictor of all-cause mortality for hemodialysis patients.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diálise Renal / Pulmão Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: Zh Ano de publicação: 2017 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Diálise Renal / Pulmão Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Female / Humans / Male Idioma: Zh Ano de publicação: 2017 Tipo de documento: Article