应用超声心动图结合心胸比评估血液透析患者干体质量

Assessment of dry weight in hemodialysis patients with echocardiography combined cardiothoracic ratio

目的探讨应用心脏超声参数结合心胸比值（CTR）在评估血液透析患者干体质量中的意义。方法选择血液透析患者53例，根据症状、体征分为3组，即A组为干体质量低估者14例；B组为干体质量高估者24例；c组为干体质量合适者15例。测定各组透析前血压、左房收缩末期内径（LAD）、CTR，根据结果调整于体质量，分析LAD结合CTR在评估维持性血液透析患者干体质量中的作用。结果A组LAD、CTR偏低；B组LAD、CTR偏高，调整干体质量，患者症状改善，LAD、CTR至正常范围；C组9例患者LAD与CTR均在正常范围，未调整干体质量。5例LAD〉40m呱或CTR〉0．52，适当降低干体质量，无低血压及肌肉痉挛。结论超声心动图LAD结合CTR、临床症状有助于评估维持性血液透析患者干体质量。

Objective To investigate the application of cardiac ultrasound parameters combined cardiothoracic ratio（CTR） in the assessment of dry weight among maintenance hemodialysis patients （MHD）. Methods 53 patients undergoing maintenance hemodialysis were divided into three groups according to their symptoms and physical signs., group A, 14 dry weight underestimated patients; group B, 24 dry weight overestimated patients; group C, 15 dry weight appropriate patients. Predialys- is blood pressure, left atrial systolic diameter（LAD）, CTR were determined in these patients and dry weights were adjusted according to the results. Then we analysised the role of LAD combined CTR in the assessment of dry weight in MHD. Results LAD and CTR were low in group A while they were high in group B. The symptoms were improved by adjusting the dry weight with LAD and CTR becom- ing normal. In group C,The dry weight were not adjusted in the 9 patients since the LAD and CTR were normal. And they were reduced in 5 cases of LAD〉40mm or CTR〉0. 5. There were no hypoten- sion and muscle spasms. Conclusions LAD combined CTR and clinical symptoms contribute to the as- sessment of dry weight of MHD.