摘要
目的观察每天短时血液透析(s DHD)对尿毒症患者心脏功能的影响。方法采用序贯治疗法对30例慢性肾功能衰竭患者进行常规血液透析(CHD)治疗2个月后,转为s DHD治疗2个月。观察治疗前后患者的血常规、血清总蛋白(TP)、清蛋白(Alb)及肾功能,计算患者的溶质清除指数(SRI)、时间平均尿素浓度(TACurea),测定患者干体质量(DW),观察透析过程中患者的血压波动情况及四肢抽搐发生率变化,心脏彩色多普勒检查CHD和s DHD治疗前后患者心脏的A峰与E峰流速比值(E/A)和左心室射血分数(LVEF)变化。结果与CHD比较,s DHD治疗2个月后,其反映患者透析充分性的指标SRI和TACurea较治疗前明显改善,患者DW、血清TP、Alb及血红蛋白(Hb)指标较治疗前均明显增加,差异均有统计学意义(P<0.05)。透析低血压、高血压、抽搐发生率及透析后体质量变化较CHD期间明显降低。而反映心脏左心室舒张功能的心脏二尖瓣口血流频谱E/A较治疗前明显减低,E/A<1的患者增多,反映心脏收缩功能的LVEF较治疗前明显增加,差异均有统计学意义(P<0.05)。结论与CHD比较,s DHD能够保证患者透析的充分性,改善患者的营养状况,减少透析相关的急性并发症、改善患者的心功能。
Objective To observe the effect of short-daily hemodialysis(s DHD) on the heart function of uremic patients.Methods The sequential treatment was adopted to conduct the conventional hemodialysis(CHD) for 2 months and then 2-month s DHD in 30 cases of chronic renal failure. Routine blood test,serum total protein(TP),albumin(Alb) and kidney function before and after treatment were detected,the solute removal index(SRI) and time-average concentration of urea(TACurea) were calculated,the dry weight(DW) was measured. The blood pressure fluctuation situation and the occurrence rate change of limbs twitch during hemodialysis process were observed. The changes of cardiac A peak to E peak flow velocity ratio(E/A) and LVEF before and after CHD and s DHD were measured by using the color Doppler echocardiography. Results Compared with CHD,SRI and TACurea as reflecting hemodialysis adequacy indicators after 2-month s DHD were significantly improved compared with before treatment,DW,serum TP,Alb and Hb were significantly increased compared with before treatment,the differences were statisti cally significant(P〈0.05). The occurrence rates of dialysis hypotension,hypertension and convulsion and body mass change after dialysis were decreased compared with the CHD period. The E/A ratio as reflecting the left ventricular diastolic function was sig-nificantly reduced compared with before treatment,the patients number of E/A1 was increased,LVEF as reflecting cardiac systolic function was significantly increased compared with before treatment,the differences were statistically significant(P〈0.05).Conclusion Compared with CHD,s DHD could ensure the dialysis adequacy,improves the nutritional status of patients,reduces the incidence of acute dialysis-related complications and improves the cardiac function of patients.
出处
《现代医药卫生》
2016年第4期494-496,共3页
Journal of Modern Medicine & Health
基金
重庆市卫生计生委科研基金资助项目(2011-2-478)
关键词
尿毒症
肾透析
短时血液透析
心脏功能
Uremia
Renal dialysis
Short-daily hemodialysis
Heart function