The value of high-flux hemodialysis in improving left ventricular function in patients with uremia evaluated by ultrasound
Liu Wenyuan1,Wang Min3,Liu Yudong2,Zhao Hanhui1,Qin Yu1,Dong Lei2
1Department of Blood Purification Center,2Department of Ultrasound,Jinan Military General Hospital,Jinan 250031,China；3Department of Special Medical Treatment,89 Military Hospital of China,Weifang 261057,China
Abstract：ObjectiveTo explore the value of high-flux hemodialysis in improving left ventricular function in patients with uremia evaluated by ultrasound.MethodsSixty-seven patients with uremia who had been treated by maintenance hemodialysis were selected and divided into two groups according to the dialysis modality:conventional hemodialysis(HD)group(forty-four cases) and HFHD group(twenty-three cases).Urea nitrogen (BUN),creatinine(SCr),serum calcium(Ca),serum phosphorus(P),uric acid(UA),albumin(ALB),parathyroid hormone(PTH),tumor necrosis factor alpha(TNF-α),interleukin-6(IL-6),endothelin-1(ET-1) were detected in the two groups before treatment and six months after treatment,and left ventricular end-diastolic posterior wall thickness(LVPW),left ventricular ejection fraction (LVEF),mitral E/A value,left ventricular peak systolic mitral annular displacement (MAPSE) were measured by ultrasonography.The statistical method unpaired t test was used to analyse the data.ResultThere were no significant differences in the decreasing rates of BUN,SCr，UA,IL-6 between the HD group［(6.50±2.51）%,（-16.94±8.13）%,（-2.50±0.98）%,（-0.31±0.12）%,respectively)］ and the HFHD group［(-7.81±2.07）%,（-15.33±6.21）%,（-3.16±0.53）%,（-0.33±0.18）%,respectively］(t=-1.984,-0.830,1.684,0.543;P>0.05) after treatment，there was significant difference in the decreasing rate of serum P between the two groups ［（-5.23±2.12）%,(-11.53±4.43)%，t=-7.896,P<0.05］.The decline rates of PTH,TNFα,ET1 of the HD group［（9.62±3.55）%,（16.31±6.83）%,（21.21±8.13）%,respectively）］were lower than those of the HFHD group ［（-22.13±7.33）%，（-19.73±7.25）%,（-31.32±12.13）%，respectively)］(t=-23.960,-20.081,-21.110；P<0.05).The thickening rate of LVPW of the HD group［(0.98±2.31)%］ had no significant difference with the HFHD group［(0.43±0.17) %］ (t=1.136,P>0.05).The increasing rates of E/A,LVEF,MAPSE of the HD group［(1.42±1.16）%,（2.75±0.97）%,（2.17±0.67）%,respectively)］ were lower than those of the HFHD group［(9.02±2.74)%,(11.23±3.45)%,(17.6±4.44)%,respectively) ］(t=-15.946,-15.282,-22.716;P<0.05).ConclusionCompared with HD,HFHD can improve the left ventricular function of patients with uremia.
刘文渊 王敏 刘玉东 赵寒辉 秦瑜 董磊. 超声影像学评价高通量血液透析改善尿毒症患者左心室功能的价值[J]. 中华诊断学电子杂志, 2015, 3(1): 32-35.
Liu Wenyuan,Wang Min,Liu Yudong,Zhao Hanhui,Qin Yu,Dong Lei. The value of high-flux hemodialysis in improving left ventricular function in patients with uremia evaluated by ultrasound. zhzdx, 2015, 3(1): 32-35.
