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[慢性肾衰竭患者的左心室。血液透析前后的超声心动图和多导记录研究(作者译)]

[The left ventricle in chronic renal failure patients. Ecocardiographic and poligraphic study before and after hemodialysis (author's transl)].

作者信息

Scandiffio T, Veglia L, Dagostino F, Casino F, Guerricchio G

出版信息

G Ital Cardiol. 1979;9(7):729-33.

PMID:161534
Abstract

Echocardiographic and systolic time intervals changes found after hemodyalisis in 16 patients with chronic renal failure are analysed and discussed. Echocardiogram shows: significant (p less than 0.05), no change statistically significant of end-systolic diameter, fractional shortening, mean velocity of circumferential shortening (VcF), and amplitude of septal motion. Systolic time intervals show: significant reduction (p less than 0.001) of total electromechanical systole (SEM), mechanical systole (SM) and left ventricular ejection time (LVET), and increase (p less than 0.05) of pre-ejection period (PEP) and the ratio PEP/LVET (p less than 0.005). The reason of these changes is the post-dialytic fluid's loss (2140 +/- 760 g) followed by left ventricular end-diastolic diameter and volume reduction which decreases stoke volume and LVET (according to Frank-Starling's law). It has not been possible to draw concordant and definitive conclusions on the post-dialytic left ventricular function. PEP lengthening would give evident for myocardial involvement (but pre-load and after-load changes modifies it), while the other data are slightly affected (VcF, fractional shortening, and amplitude of septal motion) or improved (amplitude and peak velocity of posterior wall motion).

摘要

对16例慢性肾功能衰竭患者血液透析后超声心动图及收缩期时间间期的变化进行了分析和讨论。超声心动图显示:收缩末期内径、缩短分数、圆周缩短平均速度(VcF)及室间隔运动幅度无统计学显著变化(p<0.05)。收缩期时间间期显示:总电机械收缩期(SEM)、机械收缩期(SM)和左心室射血时间(LVET)显著缩短(p<0.001),射血前期(PEP)及PEP/LVET比值增加(p<0.05)(p<0.005)。这些变化的原因是透析后体液丢失(2140±760g),随后左心室舒张末期内径和容积减小,导致每搏量和LVET降低(根据Frank-Starling定律)。关于透析后左心室功能,尚未得出一致和明确的结论。PEP延长提示心肌受累(但前负荷和后负荷变化会对其产生影响),而其他数据则受到轻微影响(VcF、缩短分数和室间隔运动幅度)或有所改善(后壁运动幅度和峰值速度)。

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