透析中心夜间长时血液透析对尿毒症患者营养代谢心脏功能的远期疗效分析  

Analysis of long-term effect of in-center nocturnal hemodialysis on nutrition, metabolism and cardiac function in patients with end-stage renal disease

作　　者：刘倩[1] 蒲萌萌 杨凯 李娜[2] 张风超 Liu Qian;Pu Meng-meng;Yang Kai;Li Na;Zhang Feng-chao(Department of Nephrology,Municipal People's Hospital,Xingtai 054001,China;Department of Obstetrics,Municipal People's Hospital,Xingtai 054001,China;Department of Emergency Medicine,Municipal People's Hospital,Xingtai 054001,China)

机构地区：[1]河北省邢台市人民医院肾脏内科,054001 [2]河北省邢台市人民医院产科,054001 [3]河北省邢台市人民医院急诊科,054001

出　　处：《临床肾脏病杂志》2021年第12期992-996,共5页Journal Of Clinical Nephrology

摘　　要：目的探讨邢台市人民医院透析中心夜间长时血液透析(long-term nocturnal hemodialysis,INHD)对尿毒症患者营养代谢心脏功能的远期疗效性。方法68例患者行INHD治疗,54例患者行血液透析(hemodialysis,HD)治疗。检测患者血钙、血磷、血胆固醇、肌酐、血白蛋白、甲状旁腺激素(parathyroid hormone,PTH);计算体重指数(body mass index,BMI);测量非瘘管侧上臂肱三头肌皮褶厚度(triceps skinfold thickness,TSF);记录透析前、透析后血压;心脏彩色多普勒超声测量左心室的重量指数(left ventricular mass index,LVMI)及左心室射血分数(left ventricular ejection fraction,LVEF)。评估患者营养、代谢及心脏功能等的变化。结果随访12、36、60个月,患者血钙、肌酐、白蛋白、PTH无差异。而INHD治疗组患者血胆固醇、BMI、TSF、透前透后血压、LVMI、左心室射血分数LVEF均有改善,与CHD组患者相比差异有统计学意义。结论INHD治疗能有效降低血磷水平,预防心脏重塑,改善心脏功能,改善患者的生活质量,使患者远期获益。Objective To explore the long-term efficacy of extended nocturnal hemodialysis(INHD) on nutritional metabolism and cardiac function of uremics.Methods Both INHD(n=68) and hemodialysis(HD,n=54) were administered.Blood calcium, blood phosphorus, blood cholesterol, creatinine, blood albumin, parathyroid hormone(PTH) were measured;body mass index(BMI) was calculated;brachial triceps skinfold thickness(TSF) of upper arm was measured at non-fistula side;pre/post-dialysis blood pressure recorded;cardiac color Doppler ultrasonography of left ventricular mass index(LVMI) or left ventricular ejection fraction(LVEF) measured.The changes of nutrition, metabolism and cardiac function were assessed.Results During follow-ups of 12/36/60 months, no difference existed in serum calcium, creatinine, albumin or PTH.In INHD treatment group, blood cholesterol, BMI,TSF,pre/post-dialysis blood pressure, LVMI and LVEF all improved.As compared with coronary heart disease(CHD) patients, the differences were statistically significant.Conclusion INHD treatment can effectively reduce blood phosphorus level, prevent heart remodeling, improve heart function, enhance quality-of-life and offer long-term patient benefits.

关 键 词：血液透析 尿毒症 营养 心脏功能 

分 类 号：R692.5[医药卫生—泌尿科学]