中文摘要：

目的：探讨长期腹膜透析（PD）患者心胸比（CTR）变化特点,分析其与充血性心力衰竭（CHF）之间的联系。方法：选择国家肾脏疾病临床医学研究中心行PD置管并规律随访的终末期肾病（ESRD）患者158例,每6个月随访一次,记录胸片及心脏超声结构,计算CTR及左心室质量指数（LVMI）,同时收集患者临床及实验室检验、透析参数等指标。比较不同透析龄时患者CTR及LVMI变化趋势,分析相关影响因素,比较不同CTR患者CHF患病率及死亡率,并探索因果关系。结果：PD患者CTR逐渐增大,48月间CTR从0.467±0.039增至0.533±0.063;CHF患者CTR始终大于非CHF患者,且增加幅度更为明显;CTR较大的患者CHF患病率及死亡率均更高;透析龄、血清白蛋白（Alb）、脉压与患者CTR密切相关,体质量指数（BMI）及尿量与CTR增大独立相关。结论：PD患者随着透析龄延长其CTR逐渐增加,CTR越大则CHF患病率及死亡率均较高;Alb、脉压、BMI、尿量及透析时间是影响CTR的因素。

英文摘要：

Objective：To investigate the changes of cardiothoracic ratio（CTR） and the prevalence of congestive heart failure（CHF） in patients with long-term peritoneal dialysis（PD）. Methodology： One hundred and fifty-eight patients who received peritoneal dialysis（PD） catheterization operation and regular follow-up during January 2006 to August 2016 were enrolled in this study.All patients took chest X-ray and echocardiography every six months and calculated cardiothoracic ratio（CTR）,left ventricular mass index（LVMI） was examined. Clinical,laboratory data and dialysis parameters were also collected at the same. After analyzing total congestive heart failure（CHF） in all patients,logistic regression was used to analyze the effects of CTR. Kaplan-Meier method was used to calculate the prevalence of CHF and survival rate of the patients. Results： CTR continuously increased during the whole stage of PD,CTR of CHF patients increased significantly higher than non-CHF patients,Kaplan-Meier showed that the larger CTR patients turned to show higher prevalence of CHF rate.Dialysis age,serum albumin（Alb）,pulse pressure,body mass index and urine volume were closely related to CTR.At the end of follow-up,a total of 58 patients（36. 71%） developed CHF 30（18. 99%） patients died of CHF. Conclusion：CTR gradually increased with the extending time of PD.The higher the degree of CTR,the higher the prevalence and mortality of CHF. Alb,pulse pressure,dialysis age,body mass index and urine volume were factors affecting CTR.