CAJ | 학술논문

目的：评价并比较不同血液净化方式（血液吸附、血液透析滤过、血液透析）对肾功能衰竭患者透析后左室舒张功能的影响。方法将309例需要血液净化治疗的透析患者随机分为A组、B组、C组各103例。分别采取血液吸附联合血液透析、血液透析和血液透析滤过治疗，10个月后，对3组患者的心脏左室结构与功能指标变化进行统计学对比。结果治疗前3组心脏左室结构变化指标LVDd、LVPWT、IVST、LAD差异无统计学意义（P＞0．05）；治疗10个月后，3组患者LAD明显增大（P＜0．05），LVDd明显缩短（P＜0．05）；LVDd指标中A组与C组明显优于B组（P＜0．05），而A组与C组比较差异无统计学意义（P＞0．05）；LAD组间差异不显著（P＞0．05）。3组治疗前后LVPWT和IVST差异均无统计学意义（P＞0．05）。治疗前3组心功能E／A、LVEF水平比较差异无统计学意义（P＞0．05）；治疗后E／A、LVEF较治疗前有显著变化（P＜0．05）。 A组与C组明显优于B组（P＜0．05），而A组与C组比较差异无统计学意义（ P＞0．05）。结论血液吸附、血液透析滤过及血液透析均能在临床上改善心功能，但是血液吸附和血液透析过滤能更好的维持内环境，优于血液透析技术。
목적：평개병비교불동혈액정화방식（혈액흡부、혈액투석려과、혈액투석）대신공능쇠갈환자투석후좌실서장공능적영향。방법장309례수요혈액정화치료적투석환자수궤분위A조、B조、C조각103례。분별채취혈액흡부연합혈액투석、혈액투석화혈액투석려과치료，10개월후，대3조환자적심장좌실결구여공능지표변화진행통계학대비。결과치료전3조심장좌실결구변화지표LVDd、LVPWT、IVST、LAD차이무통계학의의（P＞0．05）；치료10개월후，3조환자LAD명현증대（P＜0．05），LVDd명현축단（P＜0．05）；LVDd지표중A조여C조명현우우B조（P＜0．05），이A조여C조비교차이무통계학의의（P＞0．05）；LAD조간차이불현저（P＞0．05）。3조치료전후LVPWT화IVST차이균무통계학의의（P＞0．05）。치료전3조심공능E／A、LVEF수평비교차이무통계학의의（P＞0．05）；치료후E／A、LVEF교치료전유현저변화（P＜0．05）。 A조여C조명현우우B조（P＜0．05），이A조여C조비교차이무통계학의의（ P＞0．05）。결론혈액흡부、혈액투석려과급혈액투석균능재림상상개선심공능，단시혈액흡부화혈액투석과려능경호적유지내배경，우우혈액투석기술。
Objective To compared the effect of 3 kinds hemodialysis in left ventricular diastolic function of patients with renal failure.Methods 309 cases patients with hemodialysis were randomly divided into A ,B and C group,each of 103 cases.Respectively treated by blood adsorption combined with hemodialysis ,hemodialysis and hemodiafiltration therapy ,After 10 months,After 10 months,compared the cardiac structure and function index of 3 groups.Results The level of LVDd,LVP-WT,IVST and LAD of 3 groups has no statistically significant (P>0.05).Ahter 10 months,the level of LAD was higher than that before treatment(P<0.05),the LVDd was lower than that of before treatment (P<0.05).The level of LVDd of A group and C group was better than that of B group (P<0.05).The level of LVDd of group A and group C has no statistically signifi-cant(P>0.05).The level of LAD after treatment in group A、B and group C has no statistically significant (P>0.05).The level of LAD,LVPWT and IVST in group A、B and group C before and after treatment has no statistically significant ( P>0.05).The level of E/A,EF before treatment of 3 groups has no statistically significant (P>0.05).The level of E/A,EF after treatment of 3 groups was better than that before treatment ,the difference was statistically significant (P<0.05).The level of E/A,EF in group A and group C was better than that of group B ,the difference was statistically significant (P<0.05).The difference of level of E/A,EF in group A and group C has no statistically significant (P>0.05).Conclusion Hemoadsorp-tion,hemodiafiltration and hemodialysis can improve the heart function , maintain the internal environment , and the clinical effect of hemoadsorption ,hemodiafiltration was better than that of hemodialysis .