论文部分内容阅读
目的 了解尿毒症患者心肌声学密度的特征及其与血压、钙磷代谢等因素的关系。方法 根据尿毒症患者血透最初 6个月内血压水平 ,分成血压控制良好组 (A组 )和高血压组 (B组 ) ,各组取 15例患者 ,同时设健康对照组 15例 (C组 ) ,采用超声组织定征技术测量尿毒症患者和健康人群心肌背向散射积分值。结果 透析 6个月时 ,A、B两组患者的血红蛋白 (Hb)水平显著低于正常对照组 (P <0 .0 5 )。A、C组患者平均背向散射积分值 (AIB)显著低于B组 ,相应的心肌背向散射积分心动周期的变化幅度 (CVIB)显著大于B组 (P <0 .0 5 ) ,但A、C组患者AIB、CVIB组间差异无统计学意义。A组患者随访 12～ 18个月 ,配对t检验显示维持性血透患者在纠正高血压和贫血的前提下 ,其不同透析时期心肌AIB及CVIB无显著改变 ,上述心肌组织密度参数与同期血浆甲状旁腺激素 (iPTH)和钙磷水平无显著相关。结论 血压控制良好的患者心肌组织密度参数与正常人群相似。高血压是影响尿毒症心肌纤维化的主要因素。早期控制高血压很重要。尿毒症患者一旦发生心肌纤维化 ,则难以逆转
Objective To investigate the characteristics of myocardial acoustic density in patients with uremia and its relationship with blood pressure, calcium and phosphorus metabolism and other factors. Methods According to the level of blood pressure in the first six months of hemodialysis patients with uremia, the patients were divided into two groups: control group (group A) and hypertension group (group B). Fifteen patients in each group and 15 healthy controls (group C) ), Using ultrasonic tissue characterization technique to measure the integral value of myocardial backscatter in uremic patients and healthy people. Results At 6 months of dialysis, hemoglobin (Hb) levels in patients A and B were significantly lower than those in controls (P <0.05). The mean backscatter integral (AIB) of patients in group A and C was significantly lower than that in group B, and the corresponding CVSD of myocardial integrated backscatter was significantly higher than that of group B (P <0.05), but A There was no significant difference between AIB and CVIB group in C group. A group of patients were followed up for 12 to 18 months. Paired t-test showed no significant changes in myocardium AIB and CVIB in maintenance hemodialysis patients at different dialysis stages in correcting hypertension and anemia. There was no significant correlation between iPTH and calcium and phosphorus levels. Conclusions Myocardial tissue density parameters in patients with well-controlled blood pressure are similar to those in the normal population. Hypertension is a major factor that affects myocardial fibrosis in uremia. Early control of high blood pressure is very important. Uremic patients in the event of myocardial fibrosis, it is difficult to reverse