维持性血液透析患者心脏结构的变化特点分析  

Analysis of changes in cardiac structure in maintenance hemodialysis patients

作　　者：黄彬玲 沈淑琼 庄金龙 HUANG Binling;SHEN Shuqiong;ZHUANG Jinlong(Department of Nephrology,The 909th Hospital of the Joint Logistics Support Force,Southeast Hospital Affiliated to Xiamen University,Zhangzhou 363000,Fujian,China;Department of Nephrology,Joint Logistics Support Force,Southeast Hospital Affiliated to Xiamen University,Zhangzhou 363000,Fujian,China)

机构地区：[1]联勤保障部队第909医院,厦门大学附属东南医院肾内科,福建漳州363000 [2]联勤保障部队第909医院,厦门大学附属东南医院心内科,福建漳州363000

出　　处：《中南医学科学杂志》2025年第1期82-84,153,共4页Medical Science Journal of Central South China

基　　金：福建省自然科学基金资助项目(2023J011835)。

摘　　要：目的分析维持性血液透析患者心脏结构的变化特点。方法将本院血液透析患者161例,根据透析龄分为1~3年组(n=59)、3~6年组(n=24)、6~9年组(n=36)、9~12年组(n=34)、≥12年组(n=8)。比较所有患者诱导血透前后心脏结构异常发生率、心脏结构指标[左心房内径(LAD)、左心室舒张末内径(LVEDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、右心房内径(RAD)、右心室内径(RVD)]水平及左心室质量(LVM)的变化情况。比较不同透析龄组患者心脏结构指标增减幅度。结果诱导血透前所有患者存在左心房增大、左心室增大、室间隔增厚、左室后壁增厚,其中左心室增大的发生率最高。诱导血透后左心室增大的发生率较血透前明显下降(P<0.05),室间隔增厚发生率较血透前升高(P<0.05)。血液透析后LVEDD、RAD、LVM较血透前减少(P<0.05)。透析龄1~3年组患者的LVEDD、LVPWT、RAD、LVM增减幅度均低于透析3年以上的患者(P<0.05);LVM增减幅度呈现不同变化,在透析1~3年时增加,3年后开始减少,且随着透析时间的延长,减少趋势越明显。结论维持性血液透析患者随血透时间的延长,LVM呈先增后减趋势,透析3年以上LVM持续下降。Aim To analyze the characteristics of changes in cardiac structure in maintenance hemodialysis patients.Methods 161 hemodialysis patients in our hospital were divided into 1-3 year group(n=59),3-6 year group(n=24),6-9 year group(n=36),9-12 year group(n=34),and≥12 year group(n=8)based on their dialysis age.The incidence of cardiac structural abnormalities,cardiac structural indicators[left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),right atrial diameter(RAD),right ventricular diameter(RVD)]levels,and changes in left ventricular mass(LVM)in all patients before and after induced hemodialysis were compared.The changes in cardiac structural indicators among patients of different dialysis age groups were compared.Results Before inducing hemodialysis,all patients had left atrial enlargement,left ventricular enlargement,interventricular septal thickening,and left ventricular posterior wall thickening,with the highest incidence of left ventricular enlargement.The incidence of left ventricular enlargement after induced hemodialysis were decreased significantly compared with the parameters before hemodialysis(P<0.05),while the incidence of ventricular septal thickening were increased compared with the parameters before hemodialysis(P<0.05).After hemodialysis,LVEDD,RAD and LVM were decreased compared with the parameters before hemodialysis(P<0.05).The increase and decrease in LVM showed different changes,that it was increased after 1-3 years of dialysis but began to decrease after 3 years,and the decreasing trend became more pronounced with the prolongation of dialysis time.Conclusion With the increase of hemodialysis time,the LVM of maintenance hemodialysis patients shows a trend of first increasing but then decreasing,and the LVM continues to decrease after dialysis for more than 3 years.

关 键 词：维持性血液透析 心脏结构 左心室增大 

分 类 号：R692.5[医药卫生—泌尿科学]