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目的探讨增加透析频率对维持性血液透析(MHD)患者左心室重构的影响。方法MHD患者60例根据单室尿素清除指数(spKt/V)分为A组(spKt/V<1.2,36例)和B组(spKt/V≥1.2,24例),比较两组干预前(血液透析2次/周)和干预后(血液透析3次/周,至少6个月)的相关血液透析指标及彩色多普勒超声心动图指标变化。结果两组干预后,透析间期体重增加、体重增长百分比和超滤量等指标均下降,而spKt/V、每周spKt/V和血红蛋白等指标升高(P<0.05)。两组干预后左心室后壁厚度、左心室舒张末期内径、左心室质量和左心室重量指数均下降,而左心室射血分数、舒张早期/舒张晚期峰值比升高(P<0.01)。结论增加血液透析频率能逆转MHD患者左心室重构,有利于改善心室收缩和舒张功能。
Objective To investigate the effect of increasing dialysis frequency on left ventricular remodeling in patients with maintenance hemodialysis (MHD). Methods Sixty patients with MHD were divided into group A (spKt / V <1.2, 36 cases) and group B (spKt / V≥1.2, 24 cases) according to single compartment urea clearance index Hemodialysis 2 times / week) and intervention (hemodialysis 3 times / week, at least 6 months) related to hemodialysis and color Doppler echocardiography changes. Results After intervention, the indices of weight gain, percentage of weight gain and ultrafiltration volume in dialysis interval decreased, while the indexes of spKt / V, weekly spKt / V and hemoglobin increased (P <0.05). Left ventricular posterior wall thickness, left ventricular end-diastolic diameter, left ventricular mass and left ventricular mass index decreased in both groups after intervention, while left ventricular ejection fraction and peak value of early diastolic / diastolic phase increased (P <0.01). Conclusions Increasing hemodialysis frequency can reverse left ventricular remodeling in patients with MHD, which is beneficial to improve ventricular systolic and diastolic function.