血液透析滤过改善尿毒症患者心脏结构的临床研究  

Study on hemodiafiltration improving heart structure in uremic patients

作　　者：唐盛[1] 闭闵[1] 刘芸芳[1] 彭小梅[1] 李瑾瑜[1] 

机构地区：[1]广西壮族自治区人民医院肾内科,广西南宁530021

出　　处：《吉林医学》2010年第29期5065-5067,共3页Jilin Medical Journal

基　　金：广西医药卫生科研课题资助(桂卫Z2007141)

摘　　要：目的:观察on-line血液透析滤过对维持性血透患者的心脏结构的影响。方法:将80例尿毒症患者运用区组随机化法,按1∶1的比例分为血液透析滤过组(HDF)和常规血液透析组(HD)。所有患者均给予相应的基础治疗,每6个月用心脏彩超检查评估心脏结构的变化,随时观察记录心脏并发症发生情况和死亡情况等。结果:2年的观察期内,HDF组和HD组分别有5例和8例死亡。治疗后彩色多普勒检查心脏结构的各项指标中HDF组均优于HD组,差异有统计学意义(P<0.05),且HDF组治疗后心脏结构较治疗前明显改善。HDF组心绞痛、心力衰竭、心律失常和心包积液等发生率显著少于HD组,差异有统计学意义(P<0.05)。结论:HDF治疗能够延缓心脏结构的改变,对防治维持性血液透析患者的心血管并发症也有一定效果。Objective To observe the effect of on-line hemodiafiltration on heart structure in patients with maintenance hemodialysis.Method Total 80 patients with uremia using block randomization method assigned to the 1∶ 1 ratio of hemodiafil-tration （ HDF） group and the conventional hemodialysis （ HD） group.All patients were given the appropriate basic treatment,every 6 months,assessed changes in cardiac structure with echocardiography,observed and recorded at any time the occurrence of cardiac complications and death situation.Results After 2 years＇ observation period,HDF group and HD group had 5 cases and 8 cases died,respectively.After treatment,color Doppler indices of cardiac structure of HDF group were better than HD group （ P 0.05） ,and cardiac structure of HDF group after treatment improved significantly compared with before treatment.Angina,heart failure,arrhythmia and pericardial effusions in HDF group were significantly less than HD group（ P 0.05） .Conclusion It indicates that HDF can delay the change of cardiac structure and cardiac dysfunction,and also has some effect on prevention and treatment of hemodialysis patients with cardiovascular complications.

关 键 词：血液透析 血液透析滤过 心脏并发症 

分 类 号：R459.5[医药卫生—治疗学]