单次血液透析过程中患者左心室舒张功能改变

Change in left ventricular diastolic function in a single hemodialysis

目的探讨血液透析过程中患者左心室舒张功能改变情况。方法行维持性血液透析患者33例,分别于单次血液透析前、血液透析30、180min及血液透析结束30min应用组织多普勒检测二尖瓣口舒张早期及晚期最大血流速度(Ee峰、Aa峰),并计算Ee/Aa。结果血液透析30min时Ee、Aa及Ee/Aa值分别为(0.62±0.19)m/s、(0.79±0.19)m/s、0.81±0.36,血液透析180min时分别为(0.70±0.21)m/s、(0.81±0.10)m/s及0.87±0.27,透析结束30min时分别为(0.72±0.22)m/s、(0.83±0.22)m/s及0.87±0.27,均低于血液透析前((0.92±0.23)m/s、(0.85±0.23)m/s、1.10±0.33)(P<0.05);血液透析30min低于血液透析180min和透析结束30min时(P<0.05)。结论单次血液透析过程中患者心脏左心室舒张功能低于透析前,血液透析30min左心室舒张功能下降明显。

Objective To explore the change of left ventricular diastolic function during a single hemodialysis. Methods Thirty-three patients receiving maintenance hemodialysis were measured the maximal velocity and time velocity integral of early or late diastole （Ea, Aa） of mitral orifice by tissue echocardiography before hemodialysis, 30 and 180 min after the beginning of hemodialysis, and 30 rain after the ending of hemodialysis. Ee/Aa was calculated. Results Ee, Aa and Ee/Aa were （0.62±0.19） m/s, （0. 79±0.19） m/s and 0. 81±0.36 in 30 min after the beginning of hemodialysis, lower than those in 180 min after the beginning of hemodialysis （（0.70±0.21） m/s, （0.81±0.10） m/s, 0. 87±0. 27） and in 30 min after the ending of hemodialysis （（0.72±0.22） m/s, （0.83±0.22） m/s, 0.87±0.27） （P〈0. 05）, and all above were significantly lower than those before hemodialysis （（0.92±0.23） m/s, （0.85±0.23） m/s, 1. 10±0.33） （P〈 0.05）. Conclusion Left ventricular diastolic function is worse during a single hemodialysis in comparison with before hemodialysis, especially in 30 min after the beginning of hemodialysis.