腹膜透析和血液透析对终末期肾病患者心脏结构和功能的影响  

Effects of peritoneal dialysis and hemodialysis on the heart structure and function of patients with end-stage renal disease

作　　者：卓建钦[1] ZHUO Jian-qin(Department of Ephropathy Rheumatism, the First People′s Hospital of Huizhou,Guangdong Province, Huizhou 516000, China)

机构地区：[1]广东省惠州市第一人民医院肾病风湿科,广东惠州516000

出　　处：《河北医科大学学报》2019年第1期38-42,共5页Journal of Hebei Medical University

基　　金：惠州市医疗卫生类科技计划项目(2017Y071)

摘　　要：目的观察腹膜透析和血液透析对终末期肾病患者心脏结构和功能的作用,并探讨患者临床指标与心脏结构和功能的相关性。方法选择终末期肾病患者180例,按照透析方式的不同分为腹膜透析组90例和血液透析组90例。比较2组残余尿量、血压、血脂和血液生化指标。2组在透析前后进行心脏彩色超声检查,观察其心脏室间隔厚度(interventricular septum thickness,IVST)、左心室后壁舒张期厚度(left ventricular pesterior wall diastolic thickness,LVPWDT)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心房前后径(left atrium diameter,LAAP)、左心室射血分数(left ventricular ejection fraction,LVEF),并计算左心室心肌重量指数(left ventricular myocardial mass index,LVMI)。将以上观察指标与LVMI进行相关分析。结果透析后,血液透析组残余尿量和总胆固醇均少于腹膜透析组,IVST、LVPWDT、LVEDD、LAAP、LVMI均大于腹膜透析组,差异有统计学意义(P<0.05)。腹膜透析组平均动脉压明显比血液透析组升高,而血白蛋白含量降低,差异有统计学意义(P<0.05)。终末期肾病患者心脏的LVMI与收缩压呈正相关(r=0.379,P<0.05),而与残余尿量、血红蛋白和低密度脂蛋白胆固醇呈负相关(r=-0.423、-0.342、-0.289,P<0.05)。结论血液透析对终末期肾病患者心脏结构和功能的影响较腹膜透析更大,腹膜透析可能是终末期肾病患者是更加理想的透析方式。Objective To observe the effect of peritoneal dialysis and hemodialysis on the heart structure and function of the patients with end-stage nephropathy,and to investigate the correlation between clinical indicators and the structure and function of the heart.Methods One hundred and eighty patients with end-stage renal disease were divided into90cases of peritoneal dialysis group and90cases of hemodialysis group according to different dialysis methods.The residual urine volume,blood pressure,blood lipids and blood biochemical parameters of the two groups were compared.All patients underwent cardiac color ultrasonography before and after dialysis,and interventricular septum thickness(IVST),left ventricular pesterior wall diastolic thickness(LVPWDT),left ventricular end diastolic diameter left ventricular end-diastolic diameter(LVEDD),left atrium diameter(LAAP),left ventricular ejection fraction(LVEF),and left ventricular myocardial mass index left ventricular myocardial mass index(LVMI)of two groups were observed.The relationships between above observations and LVMI were analyzed.Results After dialysis,the residual urine volume and total cholesterol in hemodialysis group were less than that in the peritoneal dialysis group.IVST,LVPWDT,LVEDD,LAAP,and LVMI in hemodialysis group were larger than the peritoneal dialysis group,differences were statistically significant(P<0.05).The mean arterial pressure in the peritoneal dialysis group was significantly higher than that in the hemodialysis group,while the blood albumin content was decreased,with statistically significant differences(P<0.05).The residual urine volume and mean arterial pressure were significantly different in the peritoneal dialysis group(P<0.05).In patients with end-stage renal disease,there was a positive correlation between LVMI and systolic pressure(r=0.379,P<0.05),and a negative correlation between residual urine,hemoglobin and low density lipoprotein cholesterol(r=-0.423,-0.342,-0.289,P<0.05).Conclusion Hemodialysis has a greater impact on cardiac st

关 键 词：肾病 腹膜透析 血液透析 心脏结构和功能 

分 类 号：R692[医药卫生—泌尿科学]