Objective To investigate the application value of six-minute walk test (6MWT) in patients receiving long-term hemodialysis(HD)with pulmonary hypertension (PH).Methods Ninety patients who have received HD therapy from January 2013 to June 2014 in Drum Tower Hospital were enrolled.Clinical variables and 6MWT were compared between patients with and without PH receiving hemodialysis.Results Patients with PH had lower Alb (36.61±3.76) g · L-1,Kt/V (1.30±0.27) and higher BUN (27.84±7.66) mmol · L-1,Scr(955.34±229.71) μmol · L-1 than those without PH (P ＜ 0.05).The walking distance during the 6MWT (6MWD) (192.70±65.90)m and initial SpO2 (96.11±1.05)％ were all significantly lower in the patients with PH compared with those without PH.The final Borg score of patients with PH was (4.27±1.04),significantly higher than those without PH (P ＜ 0.05).Correlation analysis showed that the systolic pulmonary arterial pressure (SPAP) had obviously negative correlation with 6MWD (r =-0.574,P ＜0.001) and initial SpO2 (r =-0.227,P=0.032),and had significantly positive correlation with final Borg score (r =0.590,P ＜ 0.001).Conclusions The 6MWT suggests that PH has a significant negative impact on functional capacity among patients receiving HD,and has the potential to be a screening tool to identify patients with PH among patients receiving HD.%目的 探讨6 min步行试验(6MWT)在血液透析(HD)并发肺动脉高压(PH)患者中的应用价值.方法 选取HD治疗的患者90例,比较并发PH(PH组)和无PH(非PH组)患者的临床资料、6MWT.结果 PH组的血白蛋白水平、尿素清除指数(Kt/V)分别为(36.61±3.76)g·L-1、(1.30±0.27),显著低于非PH组,其血尿素氮和肌酐分别为(27.84±7.66) mmol·L-1、(955.34±229.71) μmol·L-1,显著高于非PH组(P＜0.05).PH组6 min步行距离(6MWD)和起始时血氧饱和度(SpO2)分别为(192.70±65.90)m、(96.11±1.05)％,显著低于非PH组,PH组的结束时呼吸困难评分(Borg评分)为(4.27±1.04)分,显著高于非PH组(P＜0.05).相关性分析结果显示肺动脉收缩压(SPAP)和6MWD存在明显负相关关系(r=-0.574,P＜0.001);SPAP和结束时Borg呼吸困难评分存在明显正相关关系(r=0.590,P＜0.001);SPAP和6MWT起始SpO2存在明显负相关关系(r=-0.227,P=0.032).结论 6MWT可反映PH对HD患者的运动能力有一定负面影响,且有可能成为HD患者伴PH的初步筛查工具.低白蛋白血症、尿毒症毒素可能参与HD患者并发PH的发生.
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