核素运动负荷试验在慢性肾衰竭心脏泵功能损害早期诊断中的价值

The value of radionudide exercisetest for early diagnosis of heart-damaged pumping function in patients with chronic renal failure

目的观察γ-心功能仪对慢性肾衰竭（CRF）患者心功能损害的早期诊断价值，旨在了解CRF患者心脏病变特征及发展规律。方法78例CRF患者分为肾功能代偿组、氮质血症组及尿毒症组，18例正常人为对照组。测定心率（HR），心室射血分数（EF），心搏量（SV），射血率（ER），相对心血排量（Rco），充盈率（FR），高峰充盈率（PRF）及高峰充盈时间（TPER）的指标。结果静态下各组患者右心功能参数无显著改变（P〉0．05），左心功能参数存在不同程度的异常。运动负荷后，左、右心均出现不同程度的收缩期及舒张期储备功能下降，左心较右心严重，且随CRF的发展，下降程度越明显。结论放射性核素运动负荷试验可作为CRF心脏泵功能损害的早期检测手段。

Objective To investigate the feature and developing rule of heart-damaged in chronic renal failure（CRF）. Method Bi-ventricular function of 78 patients with CRF were measured by radionuclide exercise test. They were classified into three groups： compensatory （22 cases）, azotemia （25 cases） and uremia group （31 cases）. Meanwhile, 18 healthy subjects served as norrhals control. The heart function parameters were recorded by the instrument. Results The parameter of the right heart function in all groups were not significantly damaged uringrest. The different degrecs ahnormatities of diastolic function of left ventriclc dcuring rest were founly demeged duriag rest, were found in each group, After loading test, there were various degrees of reducement of syslolic and diastolic reserve capaci in all groups, This decrease became more significont and coincided with the progressia of CRF. We also found that left ventricular lesion was more severe and occured earlier than right one. Conclusions We consider radionuclide exercise test is a sensitive method for early detection of heart pumping dysfunction.