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通过测量血液透析患者的脉搏波速度和脉搏传播时间来确定超滤对主动脉力学特性的急性影响。

Acute effects of ultrafiltration on aortic mechanical properties determined by measurement of pulse wave velocity and pulse propagation time in hemodialysis patients.

作者信息

Şahin Yildiz Banu, Şahin Alparslan, Başkurt Aladağ Nazire, Arslan Gülgün, Kaptanoğullari Hakan, Akın İbrahim, Yildiz Mustafa

机构信息

Department of Internal Medicine, Dr. Lütfi Kırdar Kartal Educational and Research Hospital; İstanbul-Turkey.

出版信息

Anatol J Cardiol. 2015 Apr;15(4):313-7. doi: 10.5152/akd.2014.5373. Epub 2014 Apr 16.

Abstract

OBJECTIVE

The effects of acute hemodialysis session on pulse wave velocity are conflicting. The aim of the current study was to assess the acute effects of ultrafiltration on the aortic mechanical properties using carotid-femoral (aortic) pulse wave velocity and pulse propagation time.

METHODS

A total of 26 (12 women, 14 men) consecutive patients on maintenance hemodialysis (mean dialysis duration: 40.7±25.6 (4-70) months) and 29 healthy subjects (13 women, 16 men) were included in this study. Baseline blood pressure, carotid-femoral (aortic) pulse wave velocity, and pulse propagation time were measured using a Complior Colson device (Createch Industrie, France) before and immediately after the end of the dialysis session.

RESULTS

While systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and pulse wave velocity were significantly higher in patients on hemodialysis than in healthy subjects, pulse propagation time was significantly higher in healthy subjects. Although body weight, systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and pulse wave velocity were significantly decreased, heart rate and pulse propagation time were significantly increased after ultrafiltration. There was a significant positive correlation between pulse wave velocity and age, body height, waist circumference, systolic blood pressure, diastolic blood pressure, mean blood pressure, pulse pressure, and heart rate.

CONCLUSION

Although hemodialysis treatment may chronically worsen aortic mechanical properties, ultrafiltration during hemodialysis may significantly improve aortic pulse wave velocity, which is inversely related to aortic distensibility and pulse propagation time.

摘要

目的

急性血液透析对脉搏波速度的影响存在争议。本研究的目的是使用颈股(主动脉)脉搏波速度和脉搏传播时间来评估超滤对主动脉力学特性的急性影响。

方法

本研究纳入了26例(12名女性,14名男性)维持性血液透析的连续患者(平均透析时间:40.7±25.6(4 - 70)个月)和29名健康受试者(13名女性,16名男性)。在透析 session 结束前和结束后立即使用 Complior Colson 设备(法国 Createch Industrie)测量基线血压、颈股(主动脉)脉搏波速度和脉搏传播时间。

结果

血液透析患者的收缩压、舒张压、平均血压、脉压和脉搏波速度显著高于健康受试者,而健康受试者的脉搏传播时间显著更高。超滤后,尽管体重、收缩压、舒张压、平均血压、脉压和脉搏波速度显著降低,但心率和脉搏传播时间显著增加。脉搏波速度与年龄、身高、腰围、收缩压、舒张压、平均血压、脉压和心率之间存在显著正相关。

结论

尽管血液透析治疗可能会长期恶化主动脉力学特性,但血液透析期间的超滤可能会显著改善主动脉脉搏波速度,而主动脉脉搏波速度与主动脉扩张性和脉搏传播时间呈负相关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bcf2/5336841/a2f2aa90ac63/AJC-15-313-g001.jpg

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