CAJ | 학술논문

目的探讨非糖尿病肾病血液透析患者动静脉内瘘血流量对心功能的影响。方法以在本院就诊的186例采用动静脉内瘘行血液透析的非糖尿病肾病患者为研究对象，观察分析其动静脉内瘘血流量、心输出量及心功能情况。结果经不同模型间比较，血流量与心输出量的关系采用三阶多项式进行拟合可取得最优效果。按照＜0.90 L/min，0.90～2.20 L/min，＞2.20 L/min将血流量分为三组，三组间心输出量、心肺再循环比值的差异均具有显著性（P＜0.01）。血流量＞2.20 L/min的患者有较高的心力衰竭比例，与其他两组相比差异也具有显著性（P＜0.01）。结论长期、高流量的动静脉内瘘可显著影响血液透析患者的心功能，主要表现在心输出量和心肺再循环等方面；动静脉内瘘和心输出量、血流量之间的关系是复杂的，可以采用三阶多项式回归模型初步拟合这种关系；高血流量患者易发生心力衰竭。
목적탐토비당뇨병신병혈액투석환자동정맥내루혈류량대심공능적영향。방법이재본원취진적186례채용동정맥내루행혈액투석적비당뇨병신병환자위연구대상，관찰분석기동정맥내루혈류량、심수출량급심공능정황。결과경불동모형간비교，혈류량여심수출량적관계채용삼계다항식진행의합가취득최우효과。안조＜0.90 L/min，0.90～2.20 L/min，＞2.20 L/min장혈류량분위삼조，삼조간심수출량、심폐재순배비치적차이균구유현저성（P＜0.01）。혈류량＞2.20 L/min적환자유교고적심력쇠갈비례，여기타량조상비차이야구유현저성（P＜0.01）。결론장기、고류량적동정맥내루가현저영향혈액투석환자적심공능，주요표현재심수출량화심폐재순배등방면；동정맥내루화심수출량、혈류량지간적관계시복잡적，가이채용삼계다항식회귀모형초보의합저충관계；고혈류량환자역발생심력쇠갈。
Objective To investigate the influence of patients with non-diabetic renal disease hemodialysis arteriovenous ifstula blood lfow on cardiac function. Method 186 cases in our hospital with arteriovenous ifstula for hemodialysis patients with non-diabetic renal disease as the research objects, arteriovenous ifstula blood lfow, cardiac output and cardiac function in patients were observed and analyzed. Result The blood lfow and cardiac output adopting third-order polynomial Regression model could be iftted. According to<0.90 L/min, 0.90~2.20 L/min,> 2.20 L/min, blood lfow were divided into three groups, cardiac output, cardiopulmonary recirculation ratio differences were statistically signiifcant (P<0.01). 2.20 L/min more blood lfow in heart failure patients had a higher proportion compared with other groups, there was signiifcant difference (P<0.01). Conclusion Long-term, high-lfow arteriovenous ifstula can signiifcantly affect cardiac function in hemodialysis patients, relfected in cardiac output and cardiopulmonary recirculation, etc. Arteriovenous ifstula and cardiac output, blood lfow volume has a complex relationship, we can use third-order polynomial regression model to ift this relationship. High blood lfow in patients is prone to heart failure.