1、肺动脉高压的定义 Systolic pulmonary arterial pressure （PAP） PAP=cardiac output x PVR 65 重度 Seminars in Dialysis,2006 353-35725mmHg Mahans equation: right ventricular outflow tract flow acceleration timeMPAP(mmHg)=79-0.45X acceleration time(ms)Cardiac output(ml/min)=stroke volume(ml)Xheart rate(min-1)stroke
2、volume from end-diastolic volumeSimpsons methodmodified Bernoulli equation: PAP = tricuspid systolic jet (TR) + 10-15 mm Hg (estimated right atrial pressure: 15 mm Hg in dilated right atrium 10 mmHg in normal or slightly enlarged right atrium PHT : systolic PAP 35 mmHg.Systolic PAP=4xTR+RAP TR: tric
3、uspid regurgitation(m/sec) RAP: right artial pressure60 重度 cardiovasc Intervent Radiol 2005,28:17-22 40%血透患者：447mmHg(37-65)ESRD PH发生率与可能机制1.left heart failure 2. chronic hypoxic lung diseases. 3. Collagen vascular diseases, 5.portal hypertension4. chronic recurrent thromboembolism6.human immunodefic
4、iency virus (HIV) infection, 7.hematologic conditions 8.Secondary drugs and toxins我院血透中心不完全统计HD 27/59(45.8%) 53.015.3mmHgPD 15/51(29.4%) 40.79.7mmHgTable 1. Systolic Pulmonary arterial pressure (PAP) in hemodialysis patientsSaudi J Kidney Dis Transpl. 2008 Mar-Apr;19(2):189-93 PH相关因素 贫血、低蛋白血症 PH者心输出量更高 内皮功能（NOS-ET） AV内瘘患者、移植 内瘘血流量与通路取栓术 其它：年龄？转移性钙化PH与低蛋白血症和贫血相关 control PH Hb 11.1 1.86 9.8 1.97 p=0.012 Alb 3.75 0.44 3.38 0.32 p=0.02Saudi J Kidney Dis Transpl. 2008 Mar-Apr;19(2):189-93
