充分血液透析对尿毒症患者左心室结构和功能的影响

Effects of complete hemodialysis on cardiac structrure and function in patients with uremia

目的探讨充分血液透析对尿毒症患者左心室结构和功能的影响。方法45例尿毒症血液透析患者,在接受血液透析治疗前和治疗后第12个月时分别接受彩色多普勒超声心动图检测,测定室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末期内径(LVIDd),计算左室质量指数(LVMI);测定舒张早期充盈峰速度E峰(E)和舒张晚期充盈峰速度A峰(A),计算E/A比值,并测左室射血分数(LVEF)。结果45例尿毒症患者治疗前LVMI(153.8±29.5)g/m2、LVEF(48.8±8.3)%、E/A(0.83±0.25);充分血液透析后LVMI(113.9±25.8)g/m2、LVEF(57.7±10.6)%、E/A(1.17±0.22),超声心动图提示左室结构及功能改善。结论尿毒症血液透析患者多伴有左心室肥厚及功能障碍,充分透析可得到有效改善。

Objective To elucidate the effects of complete hemodialysis on cardiac structure and heart function in patients with uremia. Methods Forty-five uremic patients on dialytic treatment were respectively assessed with echocardiograph before accepting the hemodialysis, and on the twelfth month of complete hemodialysis. The examinatios included interventricular septum thickness（IVST）, left ventricular posterior wall thickness（LVPWT）, left ventrieular end-diastolic diameters （LVDD）, left ventricular mass index （LVMI）, left ventricular ejection fraction （LVEF）, and calculates E/A ratio. Results The LVMI,LVEF and E/A were （153.8±29.5） g/m2 , （48.8±8.3） % and （0.83± 0. 25） ,respectively, before complete hemodialysis,which were （113.9±25.8） g/m2, （57.7±10.6）% and （1.17 ±0. 22）, respectively, on the twelfth month of complete hemodialysis. The myocardial structure and heart function of the left ventricule of the all forty-five patients were improved after complete hemodialysis compaered with those before. Conclusion Regression of left ventricular hypertrophy and cardiac dysfunction are common in patients with uremia, which can be impeoved by complete hemodialysis.