高通量血液透析对维持性透析患者心血管并发症影响的临床观察

Clinical observation of effect of high-flux hemodialysis on cardiovascular complication of maintenance dialysis patients

目的初步探讨高通量血液透析(high-flux hemodialysis,HFD)对维持性血液透析患者(maintence hemodialysis,MHD)心血管疾病的影响,为临床提供资料。方法将武警北京市总队第三医院44例MHD患者随机分为两组:常规血液透析组(hemodialysis,HD组)20例,高通量血液透析组(HFD组)24例。分别在0、6、12个月时观察两组患者的临床症状,并检测血红蛋白、肌酐、尿素氮、白蛋白、血磷、β2-微球蛋白、甲状旁腺激素、C-反应蛋白等指标;心脏超声检测心脏左室收缩末期内径、左室舒张末期内径、舒张早期、舒张晚期二尖瓣口最大血流速度比,计算心功能指数、左室射血分数,并对结果进行对比分析。结果 HFD组对高血压、心肌缺血的疗效优于HD组,对心律失常的疗效两组比较差异;HFD组左心室腔径明显缩小,射血分数、心脏指数增加,与HD组比较差异有统计学意义(P<0.05)。结论 HFD可以明显改善MHD患者的心功能,减少心血管并发症的发生。

Objective To investigate the influence of high-flux hemodialysis（HFD） on cardiovascular diseases（CAD）of maintenance hemodialysis（MHD） patients,and provide information for clinic.Methods Forty-four patients with maintenance hemodialysis were randomly divided into HD group（20 cases） and HFD group（24 cases）.The clinical symptoms were observed at 0,6 and 12 months,Hb,Cr,BUN,ALB,P3-,β2-MG,iPTH,CRP and other biochemical indices were measured at the same time,left ventricular end systolic diameter（LVESD）,left ventricular end diastolic diameter（LVEDD）,Peak E,Peak A,E/A ratio were measured by echocardiogram,and the heart function index（CI）,left ventricular ejection fraction（EF） were calculated,then the obtained data were analysed.Results HFD group was superior to HD group on the curative effect of hypertension and myocardial ischemia,but there was no significant difference on arrhythmia between the two groups,in the HFD group,left ventricular cavity size was reduced,ejection fraction and cardiac index were increased,as compared with HD group,the differences were significant（P〈0.05）.Conclusion HFD can improve the heart function of patients with MHD obviously,and reduce the occurrence of cardiovascular complications.