血液净化治疗对慢性肾功能衰竭患者心血管损害的影响(附187例报告)

Effect of blood purification on cardiovascular lesions in 187 cases of chronic renal failure

目的：探讨血液净化治疗对慢性肾功能衰竭（ＣＲＦ）患者心血管损害的发生率及性质的影响。方法：以心电图、动态心电图、超声心动图检测接受腹膜透析或血液透析的１８７ 例ＣＲＦ患者的心血管损害。结果：ＣＲＦ患者的各种心血管损害的发生率为９５．２％ ，并发冠心病２０ 例（１０．７％ ），心功能失代偿１３ 例（６．９％ ），心包炎９ 例（４．８％ ）。高血压与血肌酐绝对值无关（ Ｐ＞ ０．０５）。有２１．４％ ～１００％ 的各种心电图异常可于腹膜透析后消失。结论：接受血液净化治疗的ＣＲＦ患者的各种心血管损害的总发生率仍高，但心包炎及心功能失代偿的发生率则显著减少；心血管损害的性质与程度已多不严重，部分可发生逆转。未发现有特发性心肌病变的临床依据。

Objective:To approach the effect of blood purification treatment on incidence and quality of cardiovascular loesions in 187 cases with chronic renal failure (CRF).Method:The 187 cases of CRF, accepted long terms peritoneal dialysis or hemodialysis, had been inspected for their cardiovascular system by electrocardiography, dynamic electrocardiography and echocardiography. Result:The incidence rate of various cardiovascular lesions in 187 cases of CRF were found to be 95.2 %. Among them there were coronary heart disease in 20 cases ( 10.7 %),cardiac failure in 13 cases ( 6.9 %), and epicarditis in 9 cases ( 4.8 %). Hypertension seemed to be no correlation with the value of serum cretine (P> 0.05 ). The abnormal ECG disappeared by 21.4 % to 100% after the peritoneal dialysis treatment.Conclusion:The results suggested that cardiovascular lesions in patients with CRF accepting long term blood purification treatment were quite common,but were less serious in nature and degree. They might be reversed in part by treatment. After treatment epicarditis and cardiac failure were significant decreased. These lessions cannot be confirmed to be of an specific cardiomyo pathy.