动静脉内瘘对糖尿病肾病及肾炎肾病患者左心室功能的影响

刘小平

(河北省唐山市工人医院血液透析室河北唐山063000)

[摘要]①目的探讨动静脉内瘘对糖尿病肾病与肾炎肾病患者左心室功能的影响。②方法对糖尿病肾病及慢性肾炎肾病患者于动静脉内瘘术前、术后1个月及术后3个月进行彩色多普勒超声心动图检测，测量左心室舒张期末容积指数(LVEDVI), 左心室收缩期末容积指数(LVESVI)，左心室射血分数(LVEF)。③结果糖尿病肾病内瘘组术后1个月较术前左心室容积略增大，射血分数略降低，但无统计学意义(P>0.05)；术后3个月较术前左心室容积明显增大，LVEF明显下降，有统计学意义(P<0.05)。肾炎肾病组术后1个月、3个月较术前左心室容积略增大，射血分数略降低，但无统计学意义(P>0.05)。术后3个月糖尿病肾病内瘘组较肾炎肾病组左心室容积明显增大，LVEF明显下降，有统计学意义(P<0.05)。④结论动静脉内瘘对糖尿病肾病患者左心室功能存在明显影响，可导致左心室容积增大，射血分数降低,而对肾炎肾病影响不明显。

[关键词]动静脉内瘘糖尿病肾炎左心室功能

[中图分类号]R 54[文献标识码]A

【作者简介】刘小平，女，本科，副主任护师。研究方向：血液净化。

Arteriovenous fistula in of diabetic nephropathy and nephritis kidney disease patients the influence of left ventricular functionLIUXiaoping(HebeiTangshanWorker'sHospitalRoomHemodialysis,Tangshan063000,China)

ABSTRACT[]ObjectiveExplore arteriovenous fistula in of diabetic nephropathy and nephritis kidney disease patients the influence of left ventricular function.MethodsDiabetic nephropathy and chronic nephritis,nephrotic patients with arteriovenous fistula preoperative and postoperative 1 month and 3 months after operation color Doppler echocardiography to measure left ventricular end diastolic volume index ( LVEDVI ) The left ventricular end systolic volume index(LVESVI),left ventricular ejection fraction (LVEF).ResultsDiabetic nephropathy fistula group after one month compared with preoperative left ventricular volume slightly larger,slightly lower ejection fraction,but not statistically significant(P>0.05 );3 months postoperatively compared with preoperative left ventricular volume was significantly increased and LVEF decreased significantly,with statistical significance (P<0.05).Nephritis nephropathy group was a slightly increased three months compared with preoperative left ventricular volume,ejection fraction slightly reduced,but not statistically significant(P>0.05).Fistula 3 months after surgery diabetic nephropathy group than in nephritis,nephrotic group significantly increased left ventricular volume,LVEF decreased significantly ,with statistical significance(P<0.05).ConclusionSignificant effect on the existence of arteriovenous fistula on left ventricular function of patients with diabetic nephropathy can lead to increased left ventricular volume,ejection fraction decreased.No significant effect on nephritis nephropathy.

[KEYWORDS]Aarteriovenous fistula.Diabetes.Nphritis.Left ventricular function

血液透析是终末期肾功能衰竭患者最常用的肾脏替代治疗方法之一，动静脉内瘘则是维持血液透析患者的最好血管通路，是维持性血液透析患者的生命线。但是动静脉内瘘的建立能使体内血流动力学发生变化，有些患者可导致高心输出量心力衰竭。本文通过观察糖尿病肾病及慢性肾炎肾病患者实行动静脉内瘘术后左心室功能指标的变化，以探讨动静脉内瘘对糖尿病肾病及肾炎肾病患者左心室功能有否影响。

1资料与方法

1.1一般资料选择2009年1月～2014年12月在我院肾内科接受动静脉内瘘成形术的糖尿病肾病患者53例作为观察组，其中男34例，女19例，年龄21～80岁，平均年龄(54.12±5.10)岁。所有……