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目的探讨长期血液透析(HD)患者心脏功能和结构损害的特点。方法 43例HD10年患者,其中男性25例,女性18例;开始进行HD治疗时年龄23～61岁,平均年龄41.7岁。采用彩色多普勒超声心动仪及胸部X射线,做心脏横断面观察,对心脏进行功能和结构检查。结果心脏功能Ⅰ级40例(占93.0%),Ⅱ级3例(占7.0%)。左心室射血分数为57.7%±5.1%,低于50%者仅2例;但86.0%患者存在左心室舒张功能损害,其中老年患者患病率明显高于青年和中年患者。43例患者心胸比例增大,心脏结构均已存在轻度或中度异常,表现为左心房扩大、左心室肥厚、二尖瓣及主动脉瓣瓣膜退行性改变及反流等。结论 HD 10年患者心脏左心室收缩功能大多数仍保持正常,但左心室舒张功能和心脏结构均已出现了轻度或中度损害。
Objective To investigate the features of cardiac function and structural damage in long-term hemodialysis (HD) patients. Methods 43 cases of HD10-year-old were enrolled, including 25 males and 18 females. The age of onset HD was 23 to 61 years with a mean age of 41.7 years. Using color Doppler echocardiography and chest X-ray, do the heart cross-sectional observation, the heart function and structure check. Results Grade Ⅰ in 40 cases (93.0%) and grade Ⅱ in 3 cases (7.0%). Left ventricular ejection fraction was 57.7% ± 5.1%, only 2 cases were less than 50%. However, left ventricular diastolic dysfunction was found in 86.0% of the patients, of which the prevalence was significantly higher in elderly patients than in young and middle-aged patients. 43 cases of patients with increased proportion of the heart and chest, heart structure have been mild or moderate abnormalities, manifested as left atrial enlargement, left ventricular hypertrophy, mitral valve and aortic valve degeneration and reflux and so on. Conclusion Most of the left ventricular systolic function in patients with HD at 10 years remains normal, but mild or moderate impairment of left ventricular diastolic function and cardiac structure have occurred.