中文摘要：

目的：探讨肺高压合并心包积液对维持性血液透析（MHD）患者预后的影响。方法 ：入组2009-2011年108例合并肺高压的MHD患者（其中61例伴有心包积液）,随访2年,采用生存曲线分析终点事件（全因死亡、心血管死亡和新发心血管事件）。结果：患者平均初始透析年龄为（60.2±14.1）岁,男性占55.6%,平均肺动脉压力为（53.0±15.4）mm Hg。12.0%为重度肺高压,2例（1.9%）为中至大量心包积液。随访2年,心包积液组和无心包积液组全因死亡、心血管死亡和新发心血管事件发生率分别为34.4%vs.21.3%、23.0%vs.12.8%和54.1%vs.42.6%（均P〉0.05）。生存分析显示两组在全因死亡率（Log Rank P=0.129）、心血管死亡（P=0.148）和新发心血管事件（P=0.131）方面均无差异。结论 ：与不伴心包积液的患者相比,合并心包积液的肺高压患者并不增加MHD患者终点事件。

英文摘要：

Objective Pulmonary hypertension（PH） was an independent predictor of mortality and new onset cardiovascular events in maintenance hemodialysis（MHD） patients. Recent studies revealed PH complicated by pericardial effusion（PE） increased mortality in non-CKD（chronic kidney disease） population. No such evidence existed in MHD patients. Methods We enrolled 108 MHD patients with diagnosed PH by echocardiography（61with PE） between 2009 and 2011. All patients had been followed-up for 2 years. The endpoints were all-cause mortality, cardiovascular（CV） mortality and new onset CV events. Results The mean age was（60.2 ± 14.1） years,55.6% were males and SPAP was（53.0 ± 15.4） mm Hg. 12.0% were severe PH and 1.9% were moderate-to-severe PE. The overall mortality, cardiovascular mortality and new on-set cardiovascular events in PE and non-PE group were 34.4% vs. 21.3% 、 23.0% vs. 12.8% and 54.1% vs. 42.6%, respectively（P〉0.05）. Kaplan-Meier curve showed there was no difference on all-cause mortality, CV mortality nor new-onset CV events between PE and nonPE group（Log Rank P〉0.05）. Conclusions Compared with patients without PE, the presence of PE in patients with PH did not increase the mortality and worsen the cardiovascular outcome in MHD patients.