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目的:探讨血液净化治疗对慢性肾功能衰竭(CRF)患者心血管损害的发生率及性质的影响。方法:以心电图、动态心电图、超声心动图检测接受腹膜透析或血液透析的187 例CRF患者的心血管损害。结果:CRF患者的各种心血管损害的发生率为95.2% ,并发冠心病20 例(10.7% ),心功能失代偿13 例(6.9% ),心包炎9 例(4.8% )。高血压与血肌酐绝对值无关( P> 0.05)。有21.4% ~100% 的各种心电图异常可于腹膜透析后消失。结论:接受血液净化治疗的CRF患者的各种心血管损害的总发生率仍高,但心包炎及心功能失代偿的发生率则显著减少;心血管损害的性质与程度已多不严重,部分可发生逆转。未发现有特发性心肌病变的临床依据。
Objective: To investigate the effect of blood purification treatment on the incidence and the nature of cardiovascular damage in patients with chronic renal failure (CRF). METHODS: Cardiac damage was assessed in 187 CRF patients undergoing peritoneal dialysis or hemodialysis using electrocardiogram, Holter, echocardiography. Results: The incidence of various cardiovascular lesions was 95.2% in CRF patients, 20 cases (10.7%) with coronary heart disease, 13 cases (6.9%) with decompensated heart function, 9 cases with pericarditis 4.8%). Hypertension was not related to the absolute value of serum creatinine (P> 0.05). There are 21.4% to 100% of the various ECG abnormalities disappear after peritoneal dialysis. CONCLUSIONS: The overall incidence of various cardiovascular lesions is still high in CRF patients treated with blood purification, but the incidence of pericarditis and cardiac decompensation is significantly reduced. The nature and extent of cardiovascular damage are much less severe, Some may be reversed. No clinical evidence of idiopathic cardiomyopathy was found.