摘要
目的观察老年慢性肾衰竭血液透析患者心脏瓣膜病变的性质、病因及其危险因素。方法使用彩色超声诊断仪检测121例老年尿毒症维持性血液透析(HD)患者的心脏情况,将患者分为病变组与无病变组,比较两组患者血生化检查结果。结果病变组钙磷乘积[(4.8±1.8)vs(3.8±0.5),P<0.05]、全段甲状旁腺激素[(0.831±0.184)ng/Lvs(0.386±0.128)ng/L,P<0.05]和超敏C反应蛋白[(16.6±5.2)mg/Lvs(9.8±3.5)mg/L,P<0.05]高于对照组,血红蛋白[(7.3±2.1)g/Lvs(9.6±1.8)g/L,P<0.05]、白蛋白[(32.4±4.4)g/Lvs(39.3±3.8)g/L,P<0.05]、前白蛋白[(233.7±51.6)mg/Lvs(291.3±75.6)mg/L,P<0.05]低于对照组。结论慢性肾功能衰竭维持性血液透析患者心脏瓣膜病变均以钙化为主,以二尖瓣、主动脉瓣易发,钙化不仅与原发病、钙磷乘积、继发性甲状旁腺机能亢进、血液透析年限及脱水量有关,也与贫血、炎症及营养不良显著相关。
Objective To study the etiologies,characteristics and risk factors of cardiac valve calcification（VC） with chronic renal failure（CRF） on maintenance hemodialysis aged patients. Methods Color Doppler ultrasonography was performed on 121 CRF patients. According to the results, the patients were divided into two groups, VC group and no VC group. Their hemoglobin（Hb）, plasma albumin（Alb）, pre-albumin（PAlb）, calcium-phosphate product, high c-reactive protein（HCRP） and intact parathyroid hormone（iPTH） were determined. Results Compared with no VC, serum calcium-phosphate product, parathyroid hormone and HCRP were higher in VC group; plasma albumin, pre albumin and hemoglobin were less in VC group. Conclusion Mitral and aortic valves were vulnerable to calcification, which was the major change of heart valve in patients with CRF on maintenance hemodialysis, and calcification was closely related to the primary disease, calcium-phosphate product, secondary hyperparathyroidis, longer period of hemodialysis and ultrafiltration, but to anaemia, inflammatory reaction and malnutrition.
出处
《临床荟萃》
CAS
北大核心
2006年第19期1383-1385,共3页
Clinical Focus
关键词
透析
心脏瓣膜疾病
肾功能衰竭
慢性
hemodialysis
heart valvular disease
kidney failure
chronic
