血液透析对慢性肾衰竭患者心脏功能的影响

Impact of hemodialysis on cardiac function in patients with chronic renal failure

目的了解血液透析对慢性肾衰竭患者心脏结构、功能变化的影响,分析其相关危险因素。方法回顾本院2004年1～12月透析治疗的慢性肾衰竭患者76例,分开始进入血液透析组(40例)和维持性血液透析组(36例),应用彩色超声测定左室形态及功能各项参数,测定透析前血压及各项实验室指标。结果开始进入血液透析组患者,超声心动图显示75%出现左室肥厚(LVH),30%左心室收缩功能障碍;维持性血液透析组55.6%出现LVH,左心室收缩功能正常,两组差异有统计学意义。维持性血液透析组血红蛋白、血钙、血磷、钙磷聚集和血浆白蛋白升高,C反应蛋白降低。结论维持性血液透析后,患者左心室功能改善,可能与贫血、营养不良及炎症反应的纠正有关。

Objective To evaluate the impact of hemodialysis on cardiac function in patients with chronic renal failure and to explore the related-risk factors. Methods We retrospectively reviewed chronic renal failure patients treated with dialysis in our hospital from Jan.2004 to Dec.2004. The patients were divided into initiating hemodialysis group and maintenance hemodialysls group. Cardiac structure and function were evaluated by echocardiography （echo）. Pre-hemodialysis blood pressure and other lab tests were recorded as well. Results 75% of the 40 initiating hemodialysis patients were diagnosed left ventricular hypertrophy （LVH） by echo, and 30% had left ventricular dysfunction （LVD）, compared with 55.6% LVH and none LVD among the 36 maintenance dialysis patients. The differences between the two groups were significant. Hemoglobin, serum calcium and phosphorus as well as calcium- phosphorus pwduct were elevated after maintenance hemodialysis, while CRP was reduced. Conclusion Left ventricular function were improved after maintenance hemodialysis, and it might be related to improvement of anemia, malnutrition and inflammation.