中国血液净化

›› 2005, Vol. 4 ›› Issue (12): 655-656.

• 论著 • 上一篇    下一篇

血液透析超滤量与心功能的关系

姚 峥 贾 强   

  1. 100053 北京，首都医科大学附属宣武医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2005-12-12 发布日期:2005-12-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2005-12-12 Published:2005-12-12

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摘要： 目的 探讨血液透析超滤量与心功能的关系。方法 首都医科大学宣武医院肾内科血液透析患者46例。根据透析前心功能分心力衰竭组（n=10）和非心力衰竭组（n=36）。透析中监测血压、心率和心电图，测量超滤率及超滤量与干体重之比。透析间期做心脏超声，测量左心房及左心室舒张末内径、室间隔及左心室后壁厚度、射血分数。检测血浆白蛋白和血红蛋白。结果 心力衰竭组较非心力衰竭组超滤率降低（P＜0.01），超滤量/干体重的比例降低（P＜0.05），透析中低血压、心肌缺血、心律失常、心率加快发生率高（P＜0.01）；心力衰竭组较非心力衰竭组心室壁增厚，心腔扩大，射血分数降低（P＜0.01），血浆白蛋白和血红蛋白降低（P＜0.01）。结论 心功能不稳定的患者对血液透析超滤的耐受性较差；超滤量过大，超滤速度过快，易导致心功能不全。

关键词: 血液透析, 超滤量, 心功能

Abstract: Objective To analyze the relationship between ultrafiltration volume and heart function. Methods 46 cases of hemodialysis patients were divided into heart failure group and non-heart failure group. Ultrafiltration rate and ratio of ultrafiltration volume to dry body weigh were measured. Blood pressure, heart rate and ECG were checked in hemodialysis. Echocardiography, serum albumin and hemoglobulin were checked during interhemodialysis. Results In heart failure group, ultrafiltration rate and ratio of ultrafiltration volume to dry body weight decreased (P＜0.05）, hypotension, myocardial ischemia, cardiac arrhythmia and tachycardia occurred frequently in hemodialysis (P＜0.01), level of serum of albumin and hemoglobulin decreased (P＜0.01）, cardiac enlargement presented, ejective fraction decreased (P＜0.01). Conclusion Hemodialysis patients with heart failure had poorer tolerance to ultrafiltration volume. The increased ultrafiltration rate and ratio of ultrafiltration volume to dry body weight can induce heart failure in hemodialysis.

Key words: Ultrafiltration volume, Heart function

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