残余肾功能对维持性血液透析患者营养状况及左心功能的影响

目的探讨残余肾功能（residual renal function，RRF）对维持性血液透析（MHD）患者营养状况及左心功能的影响。方法选择52例MHD患者，按RRF分为2组：有RRF组（A组）29例，RRF≥2．0ml／mim无RRF组（B组）23例，RRF〈2．0ml／min。比较2组观察开始时及观察1年后RRF、营养指标及左心功能指标。结果观察开始及1年后，A组RRF高于B组（P〈0．05）；观察开始及1年后体质量标准化蛋白质代谢率（nPCR）、血浆白蛋白、转铁蛋白、血红蛋白，A组均显著高于B组（P〈0．01或P〈0．05）；观察1年后A组的左心室射血分数（LVEF）和左心室短轴缩短率（LVFS）均高于B组（P〈0．05）。结论RRF对MHD患者营养状况及左心功能有显著影响。随着透析时间的延长，保护和监测RRF对促进MHD患者营养不良的改善及左心功能的保护均具有重要意义。

Effect of residual renal function on nutritional status and left ventricular function in maintenance hemodialysis patients

Objective To investigate the effect of residual renal function （RRF） on nutritional status and left ventrieular function in maintenance hemodialysis （MHD） patients. Methods Fifty-two maintenance hemodialysis patients were chosen. All patients were classified into two groups： 29 patients with RRF≥2. 0 mL/min （group A） ; 23 patients with RRF〈2. 0 mL/min （group B）. The impact of RRF on nutritional parameters and left ventricular function were examined respectively at the beginning of the experiment and one year later. Results At the beginning of the experiment and one year later, the mean RRF was significantly higher in group A than in group B （P〈0. 05）. During that period, the mean level of serum albumin, transferri, hemoglobin and normalized protein catabolic rate （riPeR） were significantly increased in group A as compared with those in group B （P〈0. 05）. One year later, the levels of LVEF and LVFS were significantly higher in group A than in group B （P〈 0. 05）. Conclusions RRF has a beneficial effect on nutritional status and left ventrieular function. With prolongation of dialysis time, RRF is of great significance in determining and protecting the maintenance of nutritional status and left ventricular function of MHD patients.