早期纠正贫血对慢性肾衰患者心脏结构和功能的影响

Effect of earlier treatment of anemia on the cardiac structure and function in chronic renal failure patients

目的 观察慢性肾衰病人早期纠正贫血与心脏结构和功能改变的相互关系。方法 采用临床前瞻性对照研究。血肌酐 (Scr) 133～ 4 0 4 μm ol/ L 且血红蛋白 (Hb) <110 g/ L 的 CRF患者 16例 (实验组 8例 ,对照组 8例 ) ,应用彩色多普勒超声心动图测量 8例慢性肾衰患者纠正贫血治疗 6个月前后心脏结构和功能变化的指标 ,并与对照组进行比较。结果 实验组心脏结构及功能的各项指标均较治疗前好转 ,而对照组心脏结构及功能的各项指标均持续恶化。结论 贫血是 CRF患者心脏结构改变及左心功能不全的重要原因。早期纠正贫血可使部分慢性肾衰患者左室结构和功能逆转或稳定。

Objective To investigate the changes of the cardiac structure and function in patients with chronic renal insufficiency,and analyze the relationship between these changes and earlier treatment of anemia.Methods The study was a prospective trial.sixteen patients with serum creatinine from 133 to 404 μmol/L,and with hemoglobin(Hb) levels<110 g/L were enrolled in this study.Eight patients receive EPO(experimental group),but another did not receive EPO(control group).Left ventricle diastasis diameter(LVEDD),interventricular septum(IVS),posterior wall thickness(PWTH),left ventricle ejection fraction(LVEF),left ventricular mass index(LVMI) were measured by ultrasonic-cardiography anl they were contrasted with the data of the control group.Results The levels of LVDEE,IVS,PWTh,LVEF,LVMI took a favorable turn in experimental group,while in control group the levels continually detreriorated.Conclusion Anemia is a very important factor which influences the cardiac structure and function in CRF patients.Earlier treatment of anemia can take a favorable effect on the cardiac tructure and function in CRF patients.