中文摘要：

目的分析维持性血液透析（MHD）患者肺动脉高压（PAH）发生的危险因素，及PAH与T细胞亚群的相关性。方法选取复旦大学附属中山医院血透中心MHD患者154例，按照肺动脉收缩压（PASP）〉35mmHg与否分为PAH组和non-PAH组。收集患者临床资料，用流式细胞术检测外周血T细胞、CD4T细胞、CD8T细胞、CD4CD69T细胞和CD8CD69T细胞亚群。采用Logistic回归法分析各自变量与PAH的相关性。结果PAH组56例，non-PAH组98例。两组患者间性别、年龄、透析龄、收缩压、舒张压、高血压患病率、糖尿病患病率、吸烟率、左室舒张末内径和左室收缩末内径等项目的差异无统计学意义。PAH组CD8T细胞、CD8CD69T细胞比率、左室射血分数明显低于non-PAH组；血N末端脑钠肽前体（NT—proBNP）、左房内径、室间隔厚度、左室后壁厚度明显高于non—PAH组（均P〈0．05）。两组患者CD3T细胞、CD4T细胞、CD4CD69T细胞比率、超敏C反应蛋白（hsCRP）的差异均无统计学意义。多因素Logistic回归分析结果提示，PAH与CD8T细胞和CD8CD69T细胞比率呈独立负相关（均P〈0．05）。结论MHD患者外周血CD8T细胞、CD8CD69T细胞比率下降是PAH发生的独立危险因素，CD8T细胞可能参与了PAH的发生。

英文摘要：

Objective To explore the risk factors of pulmonary artery hypertension （PAH） and the its relationship with T cell subsets to provide a foundation for the prevention and treatment of PAH. Methods 154 maintained hemodialysis （MHD） patients in our dialysis center were recruited according to the criterion and divided into two groups subsequently： PAH group （pulmonary artery systolic pressure, PASP 〉 35 mmHg） and non-PAH group （PASP≤35 mmHg）. The related clinical, biochemical and ultrasonic cardiogram data were collected and peripheral blood was acquired to detect the expressions of the surface antigen CD3, CD4, CD8 and CD69 with flow cytometry. Logistic regression analysis was used to find out the relationship between PAH and T cell subsets. Results There was no significant difference between 56 cases of PAH and 98 cases of non- PAH as regards gender, age, mean systolic and diastolic pressure, dialysis durations, morbidities of hypertension and diabetes, smoking rate, and left ventricular diameter. Compared with the non- PAH group, the PAH group demonstrated a lower percent of CD8 T cells and CD8 CD69 T cells, but a much higher left atrial diameter （LAD）, Interventricular septum thickness, left ventricular posterior wall thickness, and NT- proBNP. The percentage of T cells, CDg T cells and CD4 CD69 T cells showed no difference between the two groups. Multivariate analysis confirmed that PAH was negatively independently associated with the percentage of CD8 T cells and CD8CD69 T cells. Conclusions The decreased percentage of CD8 T cells and CDSCD69 T cells in the peripheral blood is a risk factor of PAH in maintained hemodialysis patients, and CD8 T cells may play an important role in the genesis of PAH.