On-line血液透析滤过对老年维持性血液透析患者左心结构及功能的影响

Effect of On-line Hemodiafiltration on Cardiac Structure and Function in Old Maintenance Hemodialysis Patients

目的探讨规律性on-line血液透析滤过对老年维持性血液透析患者左心室结构和功能的影响。方法我院透析室老年维持性血液透析患者50例,随机分为普通透析组(HD组)和透析+透析滤过组(HD+HDF组),于治疗前及治疗12个月后用超声心动图分别测定各患者心脏结构和功能指标(LVDd、LVVd、E/A、EF和LVMI);在以上时间点进行体检并抽取患者血标本分别检测患者CRP、β2-MG、PTH、P等。结果经不同治疗模式治疗12个月后,HD组CRP、β2-MG、PTH、血磷等指标上有轻度升高;HD+HDF组CRP、β2-MG、PTH、血磷等较治疗前均有好转;HD组在E/A、EF、LVMI等心功能指标上均有所减退,HD+HDF组的EF和LVMI较治疗前改善,差异有统计学意义。结论在老年维持性血液透析患者中采用HD+HDF模式有助于改善患者心脏结构和功能。

Objective To assess the effect and mechanism of regular hemodiafiltration on left ventricular structure and function in old maintenance hemodialysis patients. Methods Fifty old maintenance hemo dialysis patients were recruit in this Blood Purification Center,and were randomly assigned to regular hodialysis（ HD） group or regular hemodialysis plus hemodiafdtra-tion（HD＋HDF）group. Before and after 6 months of the treatment,the left ventricular structure and function parameters（LVDd, LVVd,E/A,,EF and LVMI）,the parameters（CRP,β2-MG,and PTH）were determined. Results For the patients in HD group af-ter 6 months treatment,there were no significant changes in basic condition parameters,but HD-associated chronic injury parame-ters became worse. For patients in both HD and HD＋HDF groups,all left ventricular structure and function param eters aggrava-ted,but the degree of aggravation was less in HD＋HDF group. Conclusion Regular hemodiafiltration may alleviate the damage to left ventricular structure and function in old maintenance hemodialysis patients.