维持性血液透析对老年肾衰竭患者心脏结构与功能损害的影响

 目的 探讨维持性血液透析对老年肾衰竭患者心脏结构与功能的损害及影响。方法 回顾性分析医院2017-07至2019-10收治的老年肾衰竭患者临床资料,其中维持性血液透析治疗的患者46例(观察组),未按照标准血液透析治疗的患者46例(对照组)。比较透析3个月前后两组患者血压、血常规指标水平、超声心动图检测指标水平、心电图Q-T离散度。结果 透析前两组患者血压、血常规指标水平、超声心动图检测指标水平、心电图Q-T离散度差异不明显,无统计学意义。3个月后,观察组收缩压、舒张压较对照组低,而血红蛋白、红细胞比容水平较对照组高,差异均有统计学意义(P<0.05);观察组LVEF、FS水平较对照组高,但LVEDD、LVESD、IVST、LVMI水平低,差异均有统计学意义(P<0.05);观察组Q-Td、Q-Tcd均较对照组低,差异具有统计学意义(P<0.05)。结论 老年肾衰竭患者普遍存在心脏结构和功能异常,维持性血液透析可以改善此类患者的心脏结构,减轻功能损害。

Effect of maintenance hemodialysis on cardiac structure,function and damage in elderly patients with renal failure

Objective To analyze the effect of maintenance hemodialysis on cardiac structure, function and damage in elderly patients with renal failure.Methods A retrospective analysis was performed of elderly patients with renal failure treated in Shanxi Provincial Corps Hospital between July 2017 and October 2019. Forty-six patients on standard hemodialysis and another forty-six patients on non-standard hemodialysis were assigned to the observation group and control group. Three months into dialysis, blood pressure, blood routine indexes, echocardiographic indexes, and electrocardiogram Q-T dispersion were compared between the two groups of patients.Results There were no significant differences in blood pressure, blood routine indicators, echocardiographic indicators or electrocardiogram Q-T dispersion between the two groups before dialysis (P>0.05). After three months of dialysis,the systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group, while the levels of hemoglobin and hematocrit were higher. The difference between the two groups was statistically significant (P<0.05).Besides, the levels of LVEDD, LVESD, IVST and LVMI were lower, and the difference between the two groups was statistically significant (P<0.05). Q-Td and Q-Tcd in the observation group were lower than those in the control group, and the difference between the two groups was statistically significant (P<0.05).Conclusions Abnormalities of cardiac structure and function are common in elderly patients with renal failure. Maintenance hemodialysis can effectively improve heart structure and reduce functional damage in these patients, so it should be used more widely.