血液透析对慢性肾衰患者心功能和肺弥散功能的影响及其临床意义

Effects of hemodialysis on cardiac function and lung diffusing capacity of chronic renal failure

测定20例慢性肾衰(CRF)患者血透前、后1h 的心功能、肺弥散功能变化,发现血透后心排血量(CO)、心脏指数(CI)、每搏心排血量(SV)及每搏指数(SI)均显著降低,肺一氧化碳弥散量(DLco)也显著降低,其中 SV、SI 对超滤反应敏感。结果表明,慢性肾衰患者血透后可因左室充盈压降低而导致心功能下降,并有肺弥散功能的损害。

Background The patient with chronic re- nal failure(CRF)is usually accompanied by lung-heart function disorder during hemodialysis(HD)treatment and in terms of the patients in HD treatment,this compli- cation is one of the main cause of death.To explore the mechanism which cause lung- heart function disorder during HD treatment may contribute to find a way to prevent this complication from occuring.Here we pre- sent data on the changings of cardiac func- tion and lung diffusing capacity before and after HD treatment. Experimental design The cardiac function and lung diffusing capacity were measured in 20 patients with CRF at one hour pre- and post-HD treatment.The cardiac output (CO),cardiac index(CI),stroke volume (SV),stroke index(SI)and lung carbon monoxide diffusion capacity(DLco)were measured at the same time with 2200 pul- monary function laboratory. Results CO,CI,SV and SI were signifi- cantly decreased as well as DLco in all 20 patients.There were statistical significance in SV and SI between pre-and post-HD treatment.They all obviously reduced after 5 hour HD treatment with or without ultra- filtration.DLco also markedly cut down af- ter 5 hour treatment. Conclusions These results suggest that the decrease of left ventricular filling pressure can induce the change of CO,CI,SV and SI in CRF patients after HD treatment.The impairment of lung diffusing capacity also existed in these patients.