尿毒症患者动静脉内瘘后左心结构和功能的变化

摘要

目的：探讨尿毒症患者动静脉内瘘6个月后对左心结构和功能的影响。方法：应用超声心动图检查40例尿毒症患者血液透析前和透析6个月后的左心室结构变化指标左心室舒张末期内径、左心房内径、室间隔厚度、左心室后壁厚度和左心室质量指数及相对室壁厚度和心脏收缩功能变化指标(左心室射血分数、短轴缩短率、每搏输出量、心输出量及心指数)，并进行对照分析。结果：与透析前比较，尿毒症患者动静脉内瘘6个月后，室间隔厚度、左心室后壁厚度、左心室质量指数和相对室壁厚度均下降(P<0.01)，左心室射血分数、每搏输出量、心输出量和心指数均增加(P<0.01)。动静脉内瘘前后左心室舒张末期内径、左心房内径及短轴缩短率差异均无统计学意义(P>0.05)。结论：血液透析早期部分尿毒症患者的左心室肥厚可以好转。超声心动图是检测左心结构与功能的重要方法。%Objective:To assess the left cardiac structure and function after 6 months on uremia patients undergoing arteriovenous fistula( AVF) . Methods:The indexes of left cardiac structure and systolic function were examined and analyzed by echocardiography from 40 uremia patients before and six months after AVF. The cardiac structural indexes were including left ventricular diameter of diastole(LVDd),left atrium diameter(LAD),interventricular septum(IVS),left ventricular posterior wall(LVPW),left ventricular mass index(LVMI) and relative wall thickness(RWT);the systolic functional indexes were including ejection fraction(EF),fraction shorten(FS),strove volume(SV),cardiac output(CO) and cardiac index(CI). Results:Compared with echocardiographic indexes before AVF,after treatment for 6 months,IVS,LVPW,LVMI and RWT were decreased(P<0. 05);EF,SV,CO and CI were increased (P<0. 01). There were no significant differences on LVDd,LAD and FS(P>0. 05). Conclusions:Part of uremia patients with left ventricular hypertrophy can be improved in the early period of AVF. Echocardiography is an important method for detection the left cardiac structure and function.