血透对慢性肾功能衰竭患者心脏结构和功能的影响

目的 探讨慢性肾功能衰竭（ＣＲＦ）患者心脏结构和功能的改变及血液透析对心脏的影响。方法 ４０例正常对照及２０例慢性肾衰患者血透前后分别用彩色多普勒超声心动图（ＵＣＧ）进行心脏结构和功能的测定，并监测透析前后血压、肾功能的变化。结果 ＣＲＦ患者与正常对照组相比，ＳＢＰ显著升高（Ｐ〈０．０１），ＡＯＥ降低，ＬＡＤ、ＲＡＡ、ＩＶＳＴ、ＬＶＰＷＴ及ＬＶＭＩ均明显增高（Ｐ〈０．０１），心脏收缩功能代偿性增强

Effects of Hemodialysis on Cardiac Structure and Function in Patients with Chronic Renal Failure

Objective To explore the changes of cardiac structure and function in patients with chronic renal failure (CRF) and the effects of hemodialysis on heart . OMethods Cardiac structure and function in 20 patients with CRF were assessed by echocardiogram before and after hemodialysis. Forty normal subjects were used as control group. The changes of blood pressure and biochemical parameters were investigated. Results Compared with control group ,SBP was increased significantly ( P < 0.01) . AOE was decreased and LAD ,PAA , IVST ,LVPWT were increased strongly ( P < 0.01) . Meanwhile the competitive increase of cardiac systolic function and the decrease of diastolic function were found. After hemodialysis ,SBP was lower and AOE was higher than before ,the diameter of atrials and ventricles ,LVMI and cardiac output were reduced respectively ,but cardiac diastolic function was not improved. BUN was deceased (48.7 ±15.9) mmol/ l and CRE was decreased (6.54 ±2.55) mmol/ l ( P < 0.001) .Blood pressure and left ventricular diastolic function were intimately correlated with renal function. Left ventricular hypertrophy (LVH) was positively related to cardiac systolic and diastolic function and negatively related to left ventricular diameter. Conclusion Patients with CRF were usual complicated by hypertension ,LVH and abnormal cardiac diastolic function. Hemodialysis would decrease LVMI ,but diastolic function would not be improved strongly by Hemodialysis therapy.