血液透析滤过对老年血液净化患者心脏结构及功能的远期疗效观察

Observation of long-term effectiveness of hemodiafiltration on cardiac structure and heart function in elder patients with blood purification

目的探讨血液透析滤过治疗老年血液净化患者远期心脏结构及功能的临床疗效。方法选取我科2016年9月~2017年3月维持性血液净化治疗1年以上的老年慢性肾衰患者50例,随机分成两组:血液透析滤过组和血液透析组,各25例,治疗1年。观察两组治疗后心脏结构及功能变化。结果治疗后血液透析滤过组的左心房面积、室间隔厚度、左心室后壁厚度、右心房面积、右心室前后径、左心室收缩末期直径及左心室舒张末期直径均小于血液透析组(P<0.05)。治疗后两组左心室舒张末期容积和左心室收缩末期容积均较治疗前降低,左心室射血分数较治疗前升高,且血液透析滤过组心功能指标变化幅度大于血液透析组(P<0.05)。结论血液透析滤过可有效改善老年血液净化患者的远期心脏结构和功能。

Objective To investigate the clinical effectiveness of hemodiafiltration on long-term cardiac structure and heart function in elder patients with blood purification. Methods 50 elder patients with chronic renal failure who lasted hemodiafihration more than 1 year in our department from September, 2016 to March, 2017 were randomized into hemodiafihration group and hemodialysis group with 25 patients in each. The treatment lasted for one year. The changes of cardiac structure and heart function in two groups were observed. Results After treatment, left atrial area, interventricular septal thickness, left ventricular posterior wall thickness, right atrial area, right ventricular anterior and posterior diameter, left ventricular end systolic diameter and left ventricular end diastolic diameter in hemodiafihration group were shorter than those in hemodialysis group （P〈0.05）. After treatment, left ventricular end diastolic volume and left ventricular end systolic volume in two groups decreased and left ventricular ejection fraction increased when com- pared with those before treatment （P〈0.05）. The changes of indices of heart function in hemodiafiltration group were greater than those in hemodialysis group（P〈O.05）. Conclusion Hemodiafiltraction could improve the long-term cardiac structure and heart function in elder patients with blood purification effectively.