中国血液净化

›› 2004, Vol. 3 ›› Issue (11): 592-594.

• 论著 • 上一篇    下一篇

110例慢性肾功能衰竭患者的心脏结构及心功能状况分析

康志敏 王 莉 何 强 王 芳 邹玉蓉   

  1. 610071 成都，四川省人民医院肾内科
  • 收稿日期:1900-01-01 修回日期:1900-01-01 出版日期:2004-11-12 发布日期:2004-11-12

  • Received:1900-01-01 Revised:1900-01-01 Online:2004-11-12 Published:2004-11-12

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摘要：

目的 研究分析慢性肾功能衰竭（CRF）患者左心室肥厚(LVH)、心功能异常的情况。方法 CRF患者110例，男57例，女53例。 年龄20～90岁，平均年龄(53.5±10.9)岁。其中维持性血液透析（HD）患者56例，接受肾替代治疗前(ND)患者54例。维持性血液透析患者透析前检查心脏超声左心室舒张末内径（LVEDd），室间隔舒张末厚度（IVS），左心室后壁舒张末厚度（PWTH），左心室射血分数（EF），公式计算左心室心肌重量指数（LVMI）。分析上述检查异常的发生情况。结果 110例CRF患者70.9%有LVH［LVMI：(182.56±52.90)g/m2］，32.97%存在LVEDd增大（50.03±5.39）mm，61.8%存在IVS增厚(12.14±1.55)mm，60.9%存在PWTH增厚(11.83±1.52)mm，19.1%有EF下降(60.49±10.54)%。接受肾替代治疗前的患者43%存在LVEDD增大(48.78±4.16)mm，72%存在IVS增(1.55±1.72)mm，68.5%存在PWTH增厚(11.29±1.65)mm，17.6%有左心室EF下降(60.2±13.65)%。接受肾替代治疗前患者（54例）与维持性血液透析患者（56例）比较存在较重的贫血、高血压，且LVH在接受肾替代治疗前患者中更明显。结论 本研究证实CRF患者普遍存在左心室肥厚及心功能异常，并且在接受肾替代治疗前就存在严重的左心室结构异常；提示对CRF患者早期常规心脏结构及心功能状况检查，防治LVH及心功能异常，作为降低CRF患者死亡危险的重要措施。

关键词: 空间隔舒张末厚度, 射血分数, 左心室后壁舒张末厚度

Abstract:

Objective Left ventricular hypertrophy(LVH)is one of the most important risk factors for poor prognosis in patients with chronic renal failure. We investigated the LVH and left ventricular function in patients with chronic renal failure (CRF). Methods One hundred and ten patients［male 57,female 53;mean age (53.5±10.9) years］ with CRF were enrolled in this study. There were 56 patients with maintenance hemodialysis and 54 patients with predialysis phase of CRF.Left ventriculan end diastolia dimension (LVEDD), IVS,PWTH and EF values were detected by echocardiography in all patients, and the left ventricular mass index(LVMI) was calculated in the same time. Results There were 78 patients (70.9%) with LVH ［LVMI (182.56±52.9)g/m2］， 32.97% with enlarged LVEDD （50.03 ± 5.39）mm， 61.8% with increased IVS (12.14±1.55)mm, 60.9% with increased PWT(11.83±1.52)mm，19.1% with decreased EF(60.49±10.54%). The LVH was more severe in hemodialytic patients than in those predialytic patients ［LVMI: (220.79±53.41) VS (145.69 ± 32.27), P<0.0001］. Conclusion LVH and decreased heart function was detected in most CRF patients, including those predialytic patients. Screening by echocardiography should be used to monitor and evaluate cardiac function in patients with CRF. It would be helpful to determine the optimal dialytic initiation time, and to improve the prognosis of CRF patients. 

Key words: Ejection fraction (EF), Posterior wall thickness (PWTH)

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