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残余肾功能对老年血液透析患者心血管系统的影响
The influence of Residual renal function on the cardiovascular system in elderly hemodialysis patients
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DOI:
作者:
张淳,陈俊华,黄灿茂
ZHANG Chun, CHEN Junhua, HUANG Canmao
作者单位:
武警新疆总队医院肾病科
Nephropathy Department of Armed police Xinjiang Corps Hospital
关键词:
残余肾功能;血液透析;心血管系统;心脏超声
Residual renal function; hemodialysis; cardiovascular system; echocardiographic
摘要:
目的:探讨残余肾功能对老年血液透析患者心血管系统的影响。方法:选择2009年1月至2011年6月我院肾病科进行血液透析治疗的老年患者157例,根据内生肌酐清除率(Ccr)将患者分为有RRF组和无RRF组,记录并对比两组患者的一般资料、实验室指标和超声检查结果,并对比两组透析期间心血管并发症发生率。结果:157例患者中有RRF62例,无RRF95例,而有RRF组透析时间显著低于无RRF组,差异有统计学意义(P<0.05);有RRF组血肌酐(Scr)、血尿素氮(BUN)、收缩压(SBP)、舒张压(DBP)、血磷(P)和C-反应蛋白(CRP)均显著低于无RRF组,而血钙(Ca)、血红蛋白(Hb)和白蛋白(Alb)均显著高于无RRF组,差异均有统计学意义(P<0.05);有RRF组左心室后壁厚度(LVPWT)、左心室舒张期末内径(LVEDD)和室间隔厚度(IVST)均显著低于无RRF组,而左心室射血分数(LVEF)显著高于无RRF组,差异均有统计学意义(P<0.05);有RRF组透析期间心血管并发症发生率为16.13%,显著低于无RRF组的49.47%,差异有统计学意义(P<0.05)。结论:RRF可显著缩短透析时间,控制患者血压,改善炎症状态、营养状况和钙磷代谢,减轻左心室肥厚,降低心血管并发症发生率,值得进一步深入研究。
Objective: To explore the influence of Residual renal function on the cardiovascular system in elderly hemodialysis patients.Methods: Chose 157 cases elderly patients with kidney disease who treated with hemodialysis from January 2009 - June 2011 in our hospital,they were divided into RRF group and no RRF group according to the endogenous creatinine clearance rate (Ccr).Recorded and compared the general information, laboratory indexes and ultrasound examination results between two groups,and compared the cardiovascular complications between two groups during dialysis.Results: There were 62 cases patients in RRF group while other 95 cases patients in no RRF group, and the dialysis time in RRF group was significantly lower than that in no RRF group, the difference was statistically significant (P<0.05); The levels of serum creatinine (Scr), blood urea nitrogen (BUN), systolic blood pressure (SBP), diastolic blood pressure (DBP), blood phosphorus (P) and C-reactive protein (CRP) in RRF group were significantly lower than that in no RRF group,while the blood calcium (Ca), hemoglobin (Hb) and albumin (propagated) in the RRF group were significantly higher than that in the no RRF group,the difference was statistically significant (P<0.05);The levels of left ventricular posterior wall thickness (LVPWT), left ventricular diastolic final diameter (LVEDD) and interventricular septum thickness (IVST) in the RRF group were significantly higher than that in no RRF group,while the left ventricular ejection fraction (LVEF) in the RRF group were significantly lower than that of no RRF group,the difference was statistically significant (P<0.05);The cardiovascular complication rate during dialysis in RRF group was 16.13%, it’s significantly less than that in the no RRF group, the difference was statistically significant (P<0.05).Conclusion: RRF can significantly shorten the dialysis time,control the blood pressure,improve the inflammatory state, the nutrition metabolism of calcium and phosphorus, reduce the left ventricular hypertrophy and the incidence of cardiovascular complications,worthy of further research.
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