血液透析和腹膜透析对终末期肾脏病患者心脏结构和心脏功能的影响

Effects of Hemodialysis and Peritoneal Dialysis on Cardiac Structure and Cardiac Function in Patients with Endstage Renal Disease

目的:分析血液透析和腹膜透析对终末期肾脏病患者心脏结构和心脏功能的影响。方法:选择2018年1月—2020年12月于肇庆市第一人民医院收治的终末期肾脏病并接受血液净化治疗的患者80例,将维持性血液透析患者40例作为研究1组,腹膜透析患者40例作为研究2组。对比两组实验室指标和心脏结构、功能指标。结果:透析前,两组患者血钾、血钙、血磷、甲状旁腺激素水平比较,差异无统计学意义(P>0.05);透析后,研究2组患者血磷、甲状旁腺激素水平低于研究1组,差异有统计学意义(P<0.05)。透析后,研究2组患者心脏室间隔厚度、左室后壁厚度、左室后壁舒张末期厚度、左室舒张末期内径水平均低于研究1组,左室射血分数、B型利尿钠肽水平均高于研究1组,差异有统计学意义(P<0.001)。结论:终末期肾脏病患者使用血液透析和腹膜透析均可以维持身体正常功能,但血液透析对于血磷、甲状旁腺激素的清除效果较差,对心脏造成的损伤较大,而腹膜透析可降低对心脏结构功能的影响。

Objective:To analyze the effects of hemodialysis and peritoneal dialysis on cardiac structure and cardiac function in patients with end-stage renal disease.Methods:Eighty patients with end-stage renal disease admitted to Zhaoqing First People's Hospital from January 2018 to December 2020 and receiving hemodialysis treatment were selected.Forty cases of maintenance hemodialysis patients were taken as study group 1,and forty cases of peritoneal dialysis patients were taken as study group 2.Laboratory indexes and cardiac structural and functional indexes were compared between the two groups.Results:Comparison of blood potassium,blood calcium,blood phosphorus and parathyroid hormone levels between the two groups of patients before dialysis showed no statistically significant difference(P>0.05).After dialysis,the blood phosphorus and parathyroid hormone levels of patients in study group 2 were lower than those in study group 1,and the difference was statistically significant(P<0.05).After dialysis,the levels of cardiac septal thickness,left ventricular posterior wall thickness,left ventricular posterior wall end-diastolic thickness,and left ventricular end-diastolic internal diameter of patients in study group 2 were lower than those of study group 1,and the levels of left ventricular ejection fraction and B-type natriuretic peptide were higher than those of study group 1,with statistically significant differences(P<0.001).Conclusion:Both hemodialysis and peritoneal dialysis can be used to maintain normal body functions in patients with end-stage renal disease,but hemodialysis is less effective in removing blood phosphorus and parathyroid hormone,and causes more damage to the heart,while peritoneal dialysis reduces the effects on the structural function of the heart.