摘要
目的探讨长期自体动静脉内瘘(AVF)维持性血液透析对慢性肾脏病患者心脏结构的影响。方法选取1996年10月—2019年10月收治的长期采用AVF行维持性血液透析的慢性肾脏病70例,根据不同透析龄将其分为3组,即透析龄<5年的患者为A组(17例),透析龄5~10年的患者为B组(42例),透析龄≥10年的患者为C组(11例)。观察比较3组透析治疗前和随访结束时肾功能指标、心血管并发症及心脏超声检查结果。结果随访结束时,血尿素3组总体比较差异有统计学意义(P<0.05);A组低于B组和C组,差异有统计学意义(P<0.05或P<0.01)。透析治疗前,并发高血压病所占比例3组总体比较差异有统计学意义(P<0.05);A组和B组高于C组,差异有统计学意义(P<0.05)。透析治疗前3组并发冠心病和心功能不全所占比例及随访结束时3组并发急性左心衰竭和急性心肌梗死所占比例总体比较差异无统计学意义(P>0.05)。透析治疗前,心脏超声检查正常所占比例3组总体比较差异有统计学意义(P<0.05);A组低于B组和C组,差异有统计学意义(P<0.05)。随访结束时心脏超声检查正常所占比例及透析治疗前和随访结束时其他心脏超声检查结果3组总体比较差异无统计学意义(P>0.05)。结论长期AVF维持性血液透析的慢性肾脏病患者心脏结构能维持稳定状态。
Objective To investigate the effect of autologous internal arteriovenous fistula(AVF)on cardiac structure in patients with chronic kidney disease(CKD)undergoing long-term maintenance hemodialysis.Methods Seventy CKD patients with autologous internal AVF undergoing long-term maintenance hemodialysis(MHD)admitted between October 1996 and October 2019 were selected,and the patients were divided into group A(n=17,dialysis time less than 5 years),group B(n=42,dialysis time 5-10 years)and group C(n=11,dialysis time equal or more than 10 years)according to different dialysis times.Renal function indexes,cardiovascular complications and results of cardiac ultrasonography were observed and compared before interventional dialysis treatment and at the end of follow-up among three groups.Results At the end of follow-up,there were statistically significant differences in blood urea among three groups(P<0.05);blood urea in group A was significantly lower than those in group B and C(P<0.05 or P<0.01).Before dialysis treatment,there were significant differences in the overall proportions of complicating hypertension among three groups(P<0.05),and the proportions in group A and B were significantly higher than that in group C(P<0.05).No significant differences were found in proportions of complicating coronary heart disease and cardiac insufficiency before dialysis treatment,as well as in proportions of complicating acute left heart failure and acute myocardial infarction at the end of follow-up among three groups(P>0.05).Before dialysis treatment,there were statistically significant differences in proportions of patients with normal results of cardiac ultrasound examination among three groups(P<0.05);the proportion in group A was significantly lower than those in group B and C(P<0.05).There were no statistically significant differences in proportions of patients with normal results of cardiac ultrasound examinations at the end of follow-up as well as other results of cardiac ultrasound examinations before dialysis treatment and
作者
杨新军
汪晶华
陈云爽
齐书英
赵维
黄旭东
王丽晖
吴广礼
YANG Xin-jun;WANG Jing-hua;CHEN Yun-shuang;QI Shu-ying;ZHAO Wei;HUANG Xu-dong;WANG Li-hui;WU Guang-li(Department of Nephrology,the 980th Hospital of PLA Joint Logistic Support Forces,Shijiazhuang 050082,China;Department of Vasculocardiology,the 980th Hospital of PLA Joint Logistic Support Forces,Shijiazhuang 050082,China)
出处
《临床误诊误治》
CAS
2021年第9期78-82,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省2020年度医学科学研究课题(20200232)。
关键词
肾功能不全
慢性
自体动静脉内瘘
血液透析
心脏结构
超声检查
Renal insufficiency,chronic
Autologous internal arteriovenous fistula
Hemodialysis
Cardiac structure
Ultrasonography
