血液透析滤过对尿毒症患者心脏功能的影响

The impact of hemodiafiltration on cardiac function of patients with uremia

目的观察血液透析滤过治疗对尿毒症维持性血透患者心脏功能的影响。方法将80例尿毒症患者按区组随机化以1∶1的比例分配到血液透析滤过(HDF)组和常规血液透析(HD)组。所有患者均给予相应的基础治疗,用超声心动图评估心脏收缩和舒张功能,按NYHA心功能分级法将心功能分为4级。结果 2年的观察期内,HDF组和HD组分别有5例和8例死亡。治疗后超声心动图检查示HDF组患者的心脏收缩与舒张功能均优于HD组(P<0.05),心功能分级也好于HD组(u=2.031,P=0.042)。结论 HDF治疗能够改善尿毒症维持性血透患者的心脏功能。

Objective To observe the effect of hemodiafiltration on cardiac function of patients with uremia.Methods By randomized block design,80 patients with uremia were divided into two groups with a 1：1 ratio,hemodiafiltration（HDF） group and conventional hemodialysis（HD） group.All patients were given the appropriate basic treatment and assessed cardiac systolic and diastolic function by echocardiography,and the cardiac function were divided into four degrees according to NYHA.Results In 2 years of observation,there were 5 and 8 deaths in HDF group and HD group respectively.Echocardiography showed that both systolic and diastolic function in HDF group were better than HD group（P〈0.05）,the degree of cardiac function were better in HDF group than HD group.The incidence of Acute left heart failure was lower in HDF group than the HD group（P〈0.05）,the differences were significantly.Conclusion HDF can improve cardiac function of uremic patients.