维持性血液透析患者左室结构功能变化  

Change of left vertricular diastolic function and wall corntruction of patients on maintenance haemodialysis

作　　者：张小玲[1] 陈晖[1] 邵风民[1] 程银桢[1] 

机构地区：[1]河南省人民医院,河南郑州450003

出　　处：《山东医药》2003年第28期11-12,共2页Shandong Medical Journal

摘　　要：目的　探讨维持性血液透析患者左室结构功能的变化。方法　用彩色多普勒超声检测 2 0例维持性血液透析 (HD组 )、10例高血压心脏病 (HHD组 )、10例无高血压的非梗阻性肥厚性心肌病 (HCM组 )患者、10例年龄相匹配的正常人的左心房内径 (L AD)、室间隔厚度 (IVST)、左心室后壁厚度 (L VPWT)、等容舒张时间(IRT)、舒张早期和晚期左心室充盈峰血流速度比值 (E/A)、左心室重量指数 (L VMI)。结果　 HD组和 HHD组与 HCM组相比 ,L AD、IVST、L VMI、L VPWT、IRT显著减少 (P <0 .0 5 ) ,E/A比值增高 (P <0 .0 5 ) ,L VMI、E/A比值和收缩压 (SBP)之间有相关性 (L VMI与 SBP呈正相关 ,P <0 .0 0 1;E/A比值与 SBP呈负相关 ,P <0 .0 5 )。HD组与 HHD组相比 ,L AD,IVST、L VPWT、IRT、L VMI、E/A无显著性差异 (P >0 .0 5 )。结论　 HD患者的左心室肥厚和左心室舒张功能不全与 HHD患者相似 ,但比 HCM患者轻。提示对 HD患者应严格控制血压 ,以减轻心肌肥厚 。Objective To elucidate the differences in left ventricular (LV)diastolic function of patients on maintenance haemodialysis (HD).Methods Twenty HD patients (HD group),10 patients with hypertensive heart disease (HHD group),10 patients with hypertrophic cardiomyopathy (HCM group) and 10 age-matched healthy individuals (N group)were included.The LVMI, LAD,IVST,LVPWT, IRT and E/A were examined by echocardiography.Results Compared with the HCM group, the HD and HHD group had smaller total LV wall thickness and left atrial dimension,a shorter isovolumic relaxation time and a higher ratio of peek flow velocity of early to late LV fillings (E/A).There was a correlation between LV mass index or E/A and systolic blood pressure.Conclusion HD patients have a LV diastolic dysfunction similar to that observed in HHD patients but which is less severe than that found in HCM patients.It seems reasonable to control hypertension in HD patients in order to favourably improve LV diastolic function.

关 键 词：维持性血液透析 左室结构 心肌肥厚 左心室舒张功能 高血压性心脏病 

分 类 号：R541[医药卫生—心血管疾病] R459.5[医药卫生—内科学]