尿毒症血液透析患者肺功能改变临床观察  

Clinical Observation of Pulmonary Function in Uremic Patients on Hemodilysis

作　　者：弓在春[1] 黄雯[1] 赵慧颕 杨敏[1] 王扬[2] 

机构地区：[1]首都医科大学附属北京同仁医院肾内科 [2]首都医科大学附属北京同仁医院肺功能室

出　　处：《首都医科大学学报》2006年第4期514-516,共3页Journal of Capital Medical University

摘　　要：目的观察尿毒症及血液透析患者的肺功能变化及相关影响因素。方法应用肺功能仪检测49例尿毒症患者（其中19例未透析患者，30例血液透析患者）及30例健康人的肺功能，并就血液透析患者的各项肺功能指标与血红蛋白（Hb）、血清总蛋白（TP）、白蛋白（A）、尿素氮（BUN）、肌酐（Cr）水平进行相关性分析；同时分析患者的肺功能状态与胸片改变的关系。结果尿毒症患者和血液透析患者的用力肺活量％（FVC％）、第1秒用力呼出量％（FEV1％）、用力呼气1S率％（FEV1／FVC％）、用力呼气中期流速％（FEF25％～75％）、和一氧化碳弥散量％（DLCO％）与健康人比较均有明显下降，差异具有统计学意义（P〈0．01）。维持性血液透析患者与未透析尿毒症患者相比肺通气功能、弥散功能有明显改善（P〈0．05）；患者肺弥散功能的下降与Hb的下降呈直线正相关。结论尿毒症患者的肺功能明显下降，贫血是影响肺弥散功能的原因之一，血液透析治疗及重视纠正贫血有利于改善尿毒症患者的肺功能。Objective To analyse the pulmonary function and related factors in uremic patients on hemodialysis. Methods To determine the pulmonary function of forty-nine patients with uremia （19 patients who were not on hemodialysis, 30 patients who were on hemodialysis） and 30 healthy persons. Correlative analysis was performed between parameter such as pulmonary function index and hemoglobin, plasma total albumin, albumin, Bun, Cr in hemodialysis patients; Analyze the relation between pulmonary function and chest X-ray. Results There was significant difference existed between uremic, hemodialysis patients and healthy person（P〈0.01, respectively）. The index of forced vital capacity expressed as percentages of predicted normal values （FVC%）, forced expiratory volume in one second expressed as percentages of predicted normal values（FEV1% ）, forced expiratory flow rate in one second （FEV1 / FVC% ）, forced expiratory flow between 25 % and 75 % of vital capacity expressed （FEF25 % -75 % ）, pulmonary diffusion capacity for carbon monoxide expressed as percentages of predicted normal values （DLCO%） were much lower in uremia, hemodialysis patients. There were obvious increase of ventilation and dispersion function after uremic patients on hemodialysis （P〈0.05）. There was a strong correlation between pulmonary dispersion function and hemoglobin（P〈0.05）. Conclusion There was obvious lowering of pulmonary function in uremia, anemia was one of the causes to influence the dispersion function. It is necessary to make hemodialysis and cure anemia in order to improve pulmonary function of uremic patients.

关 键 词：尿毒症 血液透析 肺功能 

分 类 号：R459.5[医药卫生—治疗学] R563[医药卫生—临床医学]