缬沙坦对维持性血液透析患者心脏功能和结构的影响

目的 探讨缬沙坦对维持性血液透析(maintenance hemodialysis,MHD)患者心脏功能和结构的影响.方法 100例MHD患者,随机分为缬沙坦治疗组与对照组,治疗前及治疗后使用超声心动图测定心脏结构指标:左房收缩末期内径(LADs)、左室舒张末期内径(LVEDd)、室间隔舒张末期厚度(IVSTd)、左室后壁舒张末期厚度(LVPWTd),左房内径指数(LAI)、左心室心肌重量指数(LVMI)、相对室壁厚度(RWT)；心脏功能指标:左室射血分数(LVEF),左室短轴缩短率(FS),二尖瓣口舒张早期和晚期最大血流速度比(E/A)各项指标测定.结果 治疗组MHD患者心脏结构指标:左房收缩末期内径(LADs)、左室舒张末期内径(LVEDd)、室间隔舒张末期厚度(IVSTd)、左室后壁舒张末期厚度(LVPWTd),左房内径指数(LAD、左心室心肌重量指数(LVMI)值均明显低于对照组,二者差异有统计学意义(P＜0.05),两组相对室壁厚度(RWT)相比没有明显的差异(P＞0.05).心脏功能指标:左室射血分数(LVEF),左室短轴缩短率(FS),二尖瓣口舒张早期和晚期最大血流速度比(E/A)值较对照组明显增高(P＜0.05).结论 缬沙坦可以改善MHD患者的心脏结构和功能.

Effect of valsartan on cardiac function and structure in maintenance hemodialysis patients

Objective To study valsartan on cardiac function and structure in maintenance hemodialysis （MHD） pa- tients. Methods 100 MHD patients were randomized into valsartan group and control group. Patients in the valsar/an group were given 80rag valsartan per day for six months. Before and after the treatment, cardiac structure echocardiography Index： Left atrial end systolic diameter （LADs）, left ventricular end diastolic diameter （LVEDd）, in- terventricular septum diastolic thickness （IVSTd）, left ventricular posterior wall diastolic thickness （LVPWTd）, left atrial diameter index （LAI）, left ventricular mass index （ LVMI）, relative wall thickness （RWT）, cardiac func- tion parameters： the cardiac function parameters, such as left ventricular ejection fraction （LVEF）, left ventricular fractional shortening （FS）,mitral early and late diastolic peak velocity ratio （E/A},were detected with echocardio- graphy. The data were statistically analyzed through SPSSI6.0. Results After 6 months, MHD patients with the treatment group cardiac structure indicators：LADs, LVEDd, IVSTd, LVPWTd, LAI, LVMI values were signifi- cantly lower than the control group, the difference was significant （P〈0.05 ）, RWT had no significant difference（P 〉0.05）. Indicators of cardiac function： LVEF, FS, E/A values were significantly higher than the control group, the difference was significant （P〈0.05）. Cenclusioas Valsartan can improve cardiac function and structure in MHD patients, and maybe contribute to the prevention and treatment of cardiovascular complications in MHD patients.