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目的评价并比较不同血液净化方式(血液吸附、血液透析滤过、血液透析)对肾功能衰竭患者透析后左室舒张功能的影响。方法将309例需要血液净化治疗的透析患者随机分为A组、B组、C组各103例。分别采取血液吸附联合血液透析、血液透析和血液透析滤过治疗,10个月后,对3组患者的心脏左室结构与功能指标变化进行统计学对比。结果治疗前3组心脏左室结构变化指标LVDd、LVPWT、IVST、LAD差异无统计学意义(P>0.05);治疗10个月后,3组患者LAD明显增大(P<0.05),LVDd明显缩短(P<0.05);LVDd指标中A组与C组明显优于B组(P<0.05),而A组与C组比较差异无统计学意义(P>0.05);LAD组间差异不显著(P>0.05)。3组治疗前后LVPWT和IVST差异均无统计学意义(P>0.05)。治疗前3组心功能E/A、LVEF水平比较差异无统计学意义(P>0.05);治疗后E/A、LVEF较治疗前有显著变化(P<0.05)。A组与C组明显优于B组(P<0.05),而A组与C组比较差异无统计学意义(P>0.05)。结论血液吸附、血液透析滤过及血液透析均能在临床上改善心功能,但是血液吸附和血液透析过滤能更好的维持内环境,优于血液透析技术。
Objective To evaluate and compare the effects of different blood purification methods (blood adsorption, hemodiafiltration, hemodialysis) on left ventricular diastolic function after dialysis in patients with renal failure. Methods A total of 309 dialysis patients who needed blood purification treatment were randomly divided into A group, B group and C group. Blood adsorption and hemodialysis, hemodialysis and hemodiafiltration were used respectively. After 10 months, the changes of cardiac left ventricular structure and function in three groups were compared statistically. Results There were no significant differences in LVDd, LVPWT, IVST and LAD between the three groups before treatment (P> 0.05). After 10 months of treatment, LAD in the three groups were significantly increased (P <0.05) (P <0.05). There was no significant difference between group A and group C (P <0.05), but the difference between group L and L was not significant (P> 0.05). There was no significant difference in LVPWT and IVST between the three groups before and after treatment (P> 0.05). There was no significant difference in E / A and LVEF levels between the three groups before treatment (P> 0.05). E / A and LVEF after treatment were significantly different from those before treatment (P <0.05). Group A and group C were significantly better than group B (P <0.05), while group A and group C had no significant difference (P> 0.05). Conclusions Blood adsorption, hemodiafiltration and hemodialysis can both improve cardiac function clinically. However, blood adsorption and hemodiafiltration can better maintain the internal environment, which is better than hemodialysis.