慢性肾功能衰竭维持性血液透析患者心脏瓣膜钙化相关因素

Cardiac valve calcification in patients with chronic renal failure on maintenance hemodialysis

目的探讨慢性肾功能衰竭维持性血液透析患者心脏瓣膜病变的性质、病因及对心脏结构和功能的影响。方法通过彩色多谱勒心动超声检查观察82例慢性肾功能衰竭维持性血液透析患者心脏瓣膜钙化的程度、瓣膜面积、狭窄或关闭不全及血生化指标。结果82例中发现二尖瓣钙化14例,二尖瓣反流8例,二尖瓣面积减少致狭窄2例,主动脉瓣钙化17例,主动脉瓣反流9例,二尖瓣并发主动脉瓣钙化11例。且钙化程度与钙磷沉积、继发性甲状旁腺功能亢进和血液透析年限密切相关。结论慢性肾功能衰竭维持性血液透析患者心脏瓣膜钙化相当常见,尤以二尖瓣、主动脉瓣易发。

Objective To investigate the etiologiy and characteristics of cardiac valve calcification and its effects on cardiac structure and function in patients with chronic renal failure （CRF） on maintenance hemodialysis. Methods The calcification, surface area, stencsis, and insufficiency of cardiac valves were measured by colour Doppler echocardiographiy. Results Among 82 patients with CRF examined echocardiographic ally, mitral valve calcification （MAC） was revealed in 14 cases, mitral regurgitation （MR） in 8 cases, mitral stenosis （MS） in 2 cases, aortic valve calcification in 17 cases, aortic regurgitation in 9 cases, and combined mitral and aortic valve cacification in 11 cases. The degree of calcification was closely related to hyperphosphoremia, secondary hyperparathyroidism, and a longer period of hemodialysis. Conclusion Mitral and aortic valves were vulnerable to calcification which was the major change of heart valve in patients with CRF on maintenance hemedialysis.