国际移植与血液净化杂志
國際移植與血液淨化雜誌
국제이식여혈액정화잡지
INTERNATIONAL JOURNAL OF TRANSPLANTATION AND HEMOPURIFICATION
2014年
3期
30-33
,共4页
周长学%陈兵%王继军%王荣
週長學%陳兵%王繼軍%王榮
주장학%진병%왕계군%왕영
肾透析%肾功能衰竭,慢性%血细胞比容%心力衰竭
腎透析%腎功能衰竭,慢性%血細胞比容%心力衰竭
신투석%신공능쇠갈,만성%혈세포비용%심력쇠갈
Renal dialysis%Kidney failure,chronic%Hematocrit%Heart failure
目的 探讨不同红细胞压积(HCT)水平对血液透析患者心脏功能及结构的影响.方法 纳入2011年6月1日至2012年5月31日枣庄市立医院维持性血液透析患者69例,透析时间最短为6个月.所有患者按照HCT水平分为5组:A组(10％≤HCT＜ 20％)9例,B组(20％≤HCT＜25％)18例,C组(25％≤HCT＜ 30％)21例,D组(30％≤HCT＜ 33％)14例,E组(HCT≥33％)7例.按照随机区组方差分析方法进行统计,分析各组透析患者心功能指标的差异,及其随不同HCT水平的变化趋势.结果 患者左心室射血分数(LVEF)水平随着HCT的升高逐渐升高,A～E组分别为(47.7±6.5)％、(55.8±1.3)％、(51.5±12.7)％、(56.7±9.5)％和(68.5±4.0)％,E组LVEF高于D组(P＜0.05).A～E组左心室收缩末内径(LVESD)分别为(38.0±7.3)、(32.4±5.9)、(41.8±9.9)、(39.3±7.7)和(33.2± 1.0)mm,C组高于B组(P＜0.05).结论 当HCT水平达到33％(血红蛋白＞110 g/L)以上并长期维持可明显改善维持性血液透析患者左心收缩功能,并减少心力衰竭的发生,对左心室肥厚亦有逆转的趋势.
目的 探討不同紅細胞壓積(HCT)水平對血液透析患者心髒功能及結構的影響.方法 納入2011年6月1日至2012年5月31日棘莊市立醫院維持性血液透析患者69例,透析時間最短為6箇月.所有患者按照HCT水平分為5組:A組(10％≤HCT＜ 20％)9例,B組(20％≤HCT＜25％)18例,C組(25％≤HCT＜ 30％)21例,D組(30％≤HCT＜ 33％)14例,E組(HCT≥33％)7例.按照隨機區組方差分析方法進行統計,分析各組透析患者心功能指標的差異,及其隨不同HCT水平的變化趨勢.結果 患者左心室射血分數(LVEF)水平隨著HCT的升高逐漸升高,A～E組分彆為(47.7±6.5)％、(55.8±1.3)％、(51.5±12.7)％、(56.7±9.5)％和(68.5±4.0)％,E組LVEF高于D組(P＜0.05).A～E組左心室收縮末內徑(LVESD)分彆為(38.0±7.3)、(32.4±5.9)、(41.8±9.9)、(39.3±7.7)和(33.2± 1.0)mm,C組高于B組(P＜0.05).結論 噹HCT水平達到33％(血紅蛋白＞110 g/L)以上併長期維持可明顯改善維持性血液透析患者左心收縮功能,併減少心力衰竭的髮生,對左心室肥厚亦有逆轉的趨勢.
목적 탐토불동홍세포압적(HCT)수평대혈액투석환자심장공능급결구적영향.방법 납입2011년6월1일지2012년5월31일조장시립의원유지성혈액투석환자69례,투석시간최단위6개월.소유환자안조HCT수평분위5조:A조(10％≤HCT＜ 20％)9례,B조(20％≤HCT＜25％)18례,C조(25％≤HCT＜ 30％)21례,D조(30％≤HCT＜ 33％)14례,E조(HCT≥33％)7례.안조수궤구조방차분석방법진행통계,분석각조투석환자심공능지표적차이,급기수불동HCT수평적변화추세.결과 환자좌심실사혈분수(LVEF)수평수착HCT적승고축점승고,A～E조분별위(47.7±6.5)％、(55.8±1.3)％、(51.5±12.7)％、(56.7±9.5)％화(68.5±4.0)％,E조LVEF고우D조(P＜0.05).A～E조좌심실수축말내경(LVESD)분별위(38.0±7.3)、(32.4±5.9)、(41.8±9.9)、(39.3±7.7)화(33.2± 1.0)mm,C조고우B조(P＜0.05).결론 당HCT수평체도33％(혈홍단백＞110 g/L)이상병장기유지가명현개선유지성혈액투석환자좌심수축공능,병감소심력쇠갈적발생,대좌심실비후역유역전적추세.
Objective The effect of hematocrit levels on cardiac function and structure in hemodialysis patients will be investigated,providing some clues for the clinical goals enacting in renal anemia patients.Methods About 69 hospitalized uremia patients receiving regular hemodialysis treatment at least 6 months between January 2011 and June 2012 in the hemodialysis center of Zaozhuang Municipal Hospital were collected in the study.The effect of hematocrit levels on cardiac function and structure in hemodialysis patients was inspected.The 69 uremia patients were divided into 5 groups according to the levels of HCT:group A (10％≤HCT＜ 20％) 9 cases,group B (20％≤HCT＜25％) 18 cases,group C (25％ ≤HCT ＜30％) 21 cases,group D (30％ ≤HCT＜ 33％) 14 cases,and group E (HCT≥33％) 7 cases.The difference in cardiac function indexes among the 5 groups was determined by Randomized Block Design Analysis of Variance (ANOVA),and the HCT related changing trends were also investigated.Results As the HCT rises,levels of LVEF were grown up accordingly,group A to group E was (47.7 ± 6.5)％,(55.8±1.3)％,(51.5± 12.7)％,(56.7±9.5)％ and(68.5 ± 4.0)％,respectively; LVEF of group E was higher than group D.LVESD of group A to group E was (38.0 ± 7.3),(32.4 ± 5.9),(41.8 ± 9.9),(39.3 ± 7.7) and (33.2 ± 1.0)mm,respectively; statistical significance was found between group B and group C(P ＜ 0.05).Conclusions The higher levels of HCT (≥ 33 ％) and long-term maintenance may significantly improve the left ventricular systolic function and reduce the chances of heart failure in hemodialysis patients.It also has the trend to reverse the left ventricular hypertrophy.
