动静脉内瘘对糖尿病肾病非透析患者心脏功能的影响  

Effects of arteriovenous fistula on structure and function of heart in patients with diabetic nephropathy receiving no hemodialysis

作　　者：王惠明[1] 何娅妮[1] 李展旭[1] 任姜汶[1] 李开龙[1] 丁涵露[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所肾内科,重庆400042

出　　处：《重庆医学》2008年第23期2725-2726,共2页Chongqing medicine

摘　　要：目的观察动静脉内瘘对糖尿病肾病非透析患者心脏功能的影响。方法选择2型糖尿病肾病伴慢性肾功能不全、在6个月内不采取肾脏替代治疗的患者30例,随机分为动静脉内瘘组及非内瘘组。在患者进入慢性肾脏疾病(CKD)4期以及行或不行动静脉内瘘术后2个月和4个月时,采用超声多谱勒检测心脏左室舒张末内径(LVEDD)及左室射血分数(LVEF)。结果2组患者心脏LVEDD及LVEF在2个月时与观察起始无明显变化;在4个月时,内瘘组LVEDD较起始明显增加(54.2±6.7与48.3±5.7,P<0.05),LVEF则明显下降(41.3±5.3与46.7±5.1,P<0.05);非内瘘组4个月时LVEDD较起始变化不明显,LVEF则有所下降,但无统计学意义。结论AVF可以导致糖尿病肾病非透析患者左心室扩大、左室射血分数降低。Objective To investigate the effects of artervenous fistula （AVF） on structure and function of heart in the patients with diabetic nephropathy receiving no hemodialysis. Methods Thirty patients with chronic renal failure caused by type 2 diabetes were selected and grouped randomly to AVF group and no-AVF group. All of the patients received no hemodialysis in the later 6 months. When the GFR decreased to a level less than 30mL/min, the patients were subjected to the surgery operation of AVF （AVF group） or not （no-AVF group）. LVEDD and LVEF were examined and analysed by Doppler echocardiography detection at the time point of 0,2 months,4 months after the renal function decreased to the level lower than 30 ml/min. Results Higher level of LVEDD and lower level of LVEF were observed at the time point of 4 months than 0 months （54.2±6.7 vs 48.3±5.7 and 41.3 ± 5.3 vs 46.7±5.1,P〈0.05） in the AVF group but not in the no-AVF group. Conclusion AVF can cause extension of LVEDD and decrease of LVEF in the stage before hemodialysis in the patients with diabetic nephropathy.

关 键 词：糖尿病肾病 动静脉内瘘 左心室功能 

分 类 号：R587.2[医药卫生—内分泌]