常规血液透析和维持性血液透析对尿毒症患者心脏结构及功能影响的对比研究

A Comparative Study on the Effects of Conventional Hemodialysis and Maintenance Hemodialysis on the Cardiac Structure and Function of Patients with Uremia

目的:采用超声联合心电图比较常规血液透析和维持性血液透析对尿毒症患者心脏结构及功能影响。方法:选取2014年2月至2014年11月我院收治的尿毒症患者110例,将其随机分为实验组和对照组,每组各55例。对照组予常规血液透析,实验组予维持性血液透析,采用碳酸氢盐透析液,透析液流量500-600 m L/min,每周透析2-3次,每次透析4h。治疗后,通过超声心动图测定室间隔厚度、左心室壁厚度、左心室舒张末内径、射血分数,采用心电图Q-T离散度分析Q-T离散度。结果:1治疗后,与对照组相比较,实验组患者EF、FS均显著降低,差异具有统计学意义(P<0.05),LVDd、LVDs、LVMI、LVH值均明显升高,差异具有统计学意义(P<0.05)。2治疗后,维持性血液透析患者的心电图Q-T离散度与对照组相比较,差异有统计学意义(P<0.05)。结论:维持性血液透析较常规血液透析能够更有效地改善尿毒症患者的心脏结构及功能。

Objective： To compare the effects of conventional hemodialysis and maintenance hemodialysis on the cardiac structure and function of patients with uremia by cardiac ultrasound and electrocardiogram （ECG）. Methods： 110 patients with uremia admitted in our hospital were selected, the patients were randomly divided into the experimental group and control group, 55 cases in each group, the control group was given conventional hemodialysis, while the experimental group was treated with maintenance hemodialysis by bicar- bonate dialysate at flow rate 500-600 mL/min, 2-3 times per week, 4 h per dialysis. After the treatment, the interventricular septum thick- ness, left ventricular wall thickness, left ventricular end diastolic diameter, ejection fraction were detected by echocardiography, and Q-T dispersion was detected by ECG. Results： After treatment, compared with the control group, the EF, FS of experimental group were.both significantly decreased （P〈0.05）, while the LVDd, LVDs, LVMI, LVH were all obviously increased （P〈0.05）, the Q-T dispersion was significantly improved （P〈0.05）. Conclusion： Maintenance hemodialysis could more effectively improve the cardiac structure and func- tion of patients with uremia.