不同透析方式对尿毒症患者心脏结构的影响-现代临床医学.docVIP

2016-05-06董 2016-5-11，主任加工 不同透析方式对尿毒症患者心脏结构的影响 向元兵，徐秀蓉 (成都大学附属医院肾内科，四川 成都 610081) [摘要]目的：比较血液透析（hemodialysis，HD）与腹膜透析(peritoneal dialysis，PD)治疗对尿毒症患者心脏结构影响。方法：选择我院住院诊断为尿毒症的患者42例，随机分为血液透析组和腹膜透析组各21例，分别于透析治疗后1个月及透析后6个月分别行心脏彩色多普勒检查，测量常规指标：左心房内径（LA）、左室舒张末径（LVEDd）、左室后壁舒张末厚度（LVPWd),室间隔舒张末厚度（IVSd)。结果：血液透析及腹膜透析治疗后1个月后较透析前LA、LVEDd、IVSd及LVPWd有明显减小（P＜0.05),6个月后LA、LVEDd、IVSd及LVPWd较1个月前亦有所减小（P＜0.05)；透析治疗1个月及6个月后腹膜透析组对心脏结构改善均明显优于血液透析组（P＜0.05)。结论：血液透析及腹膜透析均能改善尿毒症患者的心脏结构，且腹膜透析效果更优于血液透析，随着透析时间延长，心脏结构改善更明显。 [关键词]血液透析；腹膜透析；尿毒症心肌病；慢性肾衰竭 [中图分类号]R692.5 [文献标志码]A DOI:10.11851/j.issn.1673-1557.2016.03.0 Different Effects of Two Dialysis Methods on Cardiac Structure in Patients with Uremia XIANG Yuanbing,XU Xiurong (Affiliated Hospital of Chengdu University,Sicuan Chengdu 610081,China) [Abstract]Objective:To compare the impacts of hemodialysis with peritoneal dialysis on cardiac structure in patients with uremia.Methods: 42 cases with uremia in our hospital were randomly divided into hemodialysis (HD group) and peritoneal dialysis (PD group) each 21 cases. After a month and six months of dialysis,the cardiac color Doppler examination were performed to measure conventional indicators:left atrial diameter(LA),left ventricular end-diastolic diameter(LVEDd),end-diastolic wall thickness(LVPWd),end-diastolic interventricular septum thickness(IVSd).Ressults:Hemodialysis and peritoneal dialysis after a month and 6 months were compared with those dialysis ago,whose LA,LVEDd,IVSd and LVPWd reduced significantly（P＜0.05).; The cardiac structure in PD group were significantly better than in HD group after a month and six months,the difference was statistically significant（P＜0.05).Conclusion:Hemodialysis and peritoneal dialysis can improve cardiac structure of uremic patients, and peritoneal dialysis is more effective than hemodialysisfollowing prolonged dialysison improving cardiac structure. [Keywords]hemodialysis;peritoneal dialysis;Urimic cardiomyoparthy;