高通量血液透析对维持性血液透析患者心脏结构与功能的影响

目的探讨高通量血液透析(HFHD)对尿毒症维持性血液透析患者左心室结构和功能的影响。方法将64例维持性血液透析患者随机分成高通量透析组(HFHD组)和低通量透析组(LFHD组),每组各32例,入选时两组患者在临床指标和心功能指标方面无显著差异。于治疗前及6个月后用超声心动图分别测定各患者心脏结构和功能指标(LAD、LVDd、LVPWT、IVST、E/A、EF和LVMI);在以上两时间点进行体检并抽取患者血标本分别检测患者临床指标(MAP、Hb、SCr、CRP、PTH)。结果经不同治疗模式治疗6个月后,与治疗前相比,LFHD组上述指标无明显改善,而HFHD组在MAP、Hb、CRP、PTH等有改善,且LAD、LVDd、EF和LVMI等指标有明显改善。结论高通量血液透析可能有助于减轻患者心脏结构与功能损害。

Effect of high flux hemodialysis on cardiac structure and function in maintenance hemodialysis patients

Objective To investigate the effect of high flux hemodiafiltration(HFHD)on left ventricular structure and function in maintenance hemodialysis patients of uremia.Methods Sixty-four maintenance hemodialysis patients were randomly assigned to HFHD group or low flux hemodialysis(LFPD) group.There were 32 case in each group and no significant difference on parameters of clinic and cardiac structure and function at the time of recruitment.Before and after 6 months of the treatment,the left ventricular structure and function parameters(LAD,LVDd,LVPWT,IVST,E/A,EF and LVMI) by echocardiogram,and the clinic parameters(MAP,Hb,SCr,CRP,PTH) were determined.Results For the patients in LFHD group after 6 months treatment,there were no significant changes in all the parameters.For the patients in HFHD group after 6 months treatment,the clinic parameters of MAP,Hb,CRP,PTH,and the parameters of left ventricular structure and function of LAD,LVDd,EF and LVMI were markedly improved.Conclusions High flux hemodialysis may alleviate the damage to left ventricular structure and function in maintenance hemodialysis patients.