不同透析方式对尿毒症患者心脏结构的影响

Different Effects of Two Dialysis Methods on Cardiac Structure in Patients with Uremia

目的:比较血液透析(hemodialysis,HD)与腹膜透析(peritoneal dialysis,PD)治疗对尿毒症患者心脏结构的影响。方法:选择我院住院诊断为尿毒症的患者42例,随机分为血液透析组和腹膜透析组各21例,分别于透析治疗后1个月及透析后6个月行心脏彩色多普勒检查,测量常规指标:左心房内径(LA)、左室舒张末径(LVEDd)、左室后壁舒张末厚度(LVPWd)、室间隔舒张末厚度(IVSd)。结果:血液透析及腹膜透析治疗1个月后较透析前LA、LVEDd、IVSd及LVPWd有明显减小(P<0.05),6个月后LA、LVEDd、IVSd及LVPWd较1个月时亦有所减小(P<0.05);透析治疗1个月及6个月后腹膜透析组对心脏结构改善均明显优于血液透析组(P<0.05)。结论:腹膜透析及血液透析均能改善尿毒症患者的心脏结构,而腹膜透析效果更优于血液透析,随着透析时间延长,心脏结构改善更明显。

Objective: To compare the impacts of hemodialysis with peritoneal dialysis on cardiac structure in patients with uremia. Methods: 42 cases with uremia in our hospital were randomly divided into hemodialysis group( HD group) and peritoneal dialysis group( PD group) with 21 cases in each. After a month and six months of dialysis,the cardiac color Doppler examination was performed to measure conventional indicators: left atrial diameter( LA),left ventricular end-diastolic diameter( LVEDd),left ventricular end-diastolic posterior wall depth( LVPWd),interventricular end-diastolic septal diameter( IVSd). Results: LA,LVEDd,IVSd and LVPWd one month after hemodialysis and peritoneal dialysis reduced significantly compared with those before dialysis( P < 0. 05); the above indicators after six months were lower than those after one month( P < 0. 05); the cardiac structure in PD group was significantly better than that in HD group after a month and six months( P < 0. 05). Conclusion:Hemodialysis and peritoneal dialysis can improve cardiac structure of uremic patients,and peritoneal dialysis is more effective than hemodialysis. The cardiac structure is improved more with the dialysis time duration.