慢性肾功能衰竭血液透析患者心脏瓣膜病变

Valve disorders in patients with chronic renal failure on maintenance hemodialysis

目的 :探讨慢性肾功能衰竭维持性血液透析患者心脏瓣膜病变的性质、病因及对心脏结构和功能的影响。方法 :通过彩色多谱勒心动超声检查观察 6 4例慢性肾功能衰竭维持性血液透析患者心脏瓣膜钙化的程度、瓣膜面积、狭窄或关闭不全及血生化指标。结果 :6 4例患者中发现二尖瓣钙化 9例 ,二尖瓣返流 5例 ,二尖瓣面积减少致狭窄 2例 ,主动脉瓣钙化 12例 ,主动脉瓣返流 7例 ,二尖瓣并发主动脉瓣钙化 3例。结论 :慢性肾功能衰竭维持性血液透析患者心脏瓣膜病变均以钙化为主 ,尤以二尖瓣、主动脉瓣易发 ,且钙化程度与钙磷乘积、继发性甲状旁腺机能亢进和血液透析年限密切相关。

AIM:To investigate the aetiologies and characteristics of valve disorders and effects on cardiac structure and function in patients with chronic renal failure (CRF) on maintenance hemodialysis. METHODS:The calcification,surface area,stenosis and insufficiency of cardiac valve were measured by colour Dopper echocardiographic. RESULTS:Among 64 cases with CRF,the echocardiographic findings were mitral valve calcification (MAC) in 9 cases,mitral regurgitation (MR) in 5 cases,mitral stenosis (MS) in 2 cases,aortic valve calcification in 12 cases,aortic regurgitation in 7 cases,combined mitral and aortic valves cacification in 5 cases,respectively. CONCLUSION: Mitral and aortic valves were vulnerable to calcification which was the major change of heart valve in patients with CRF on maintenance hemodialysis,the degree of calcification was closely related to hyperphosphoremia,secondary hyperparathyroidism and a longer period of hemodialysis.