论文部分内容阅读
目的探索大剂量速尿对终末期肾病维持性血液透析患者的心脏结构和功能的影响。方法将本院最近3年来新进入维持性血液透析尿量在200～500 ml/24 h的终末期肾病患者随机分成2组,研究组使用呋塞米片80～160 mg/d,透析后第2天分2次口服,透析日停用;对照组不用利尿剂,观察治疗6个月,比较两组心功能、左室舒张末径(LVEDD)、左室收缩末径(LVESD)、射血分数(EF)、平均透析超滤量,血压控制情况,高血钾及尿酸等指标。结果研究组心功能明显好转,左室舒张末径、左室收缩末径明显缩小,射血分数明显增高,平均透析超滤量明显减少,平均动脉压明显下降,高血钾发生率明显减少,两组比较差异有统计学意义,P<0.05;而平均透析前尿酸差异无统计学意义,P>0.05。结论终末期肾病维持性透析患者使用大剂量呋塞米对控制水钠潴留有一定作用,使透析患者血压更容易控制,平均超滤量减少,心功能明显改善,射血分数明显增高,对减少维持性血液透析患者心血管并发症是一种经济而有效的治疗措施。
Objective To explore the effect of high-dose furosemide on cardiac structure and function in maintenance hemodialysis patients with end-stage renal disease. Methods The patients with newly diagnosed end-stage renal disease whose hemodialysis urine volume was 200-500 ml / 24 h in our hospital in recent 3 years were randomly divided into two groups. The study group used furosemide tablets 80-160 mg / d, 2 days oral 2 times, dialysis day disabled; control group without diuretic, observation and treatment of 6 months, compared two groups of heart function, left ventricular end diastolic diameter (LVEDD), left ventricular end systolic diameter (LVESD) Score (EF), average dialysis ultrafiltration volume, blood pressure control, hyperkalemia and uric acid and other indicators. Results In the study group, the cardiac function improved obviously. The left ventricular end diastolic diameter and left ventricular end systolic diameter were significantly reduced, the ejection fraction was significantly increased, the average dialysis ultrafiltration volume was significantly reduced, mean arterial pressure was significantly decreased, the incidence of hyperkalemia was significantly reduced, The difference between the two groups was statistically significant, P <0.05; mean uric acid before dialysis was no significant difference (P> 0.05). Conclusions The use of high-dose furosemide in the maintenance dialysis patients of end-stage renal disease has a certain effect on the control of Shuinazhulv so that the blood pressure of dialysis patients can be more easily controlled, the average ultrafiltration volume decreases, the cardiac function is obviously improved, the ejection fraction is obviously increased, Cardiovascular complications in maintenance hemodialysis patients is an economical and effective treatment.