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透析对终末期肾病患者最大吸气和呼气压力的影响。

Effect of Dialysis on Maximum Inspiratory and Expiratory Pressures in End Stage Renal Disease Patients.

作者信息

Tavana Sasan, Hashemian Seyed Mohammadreza, Jahromi Fatemeh Kazemi

机构信息

Department of Pulmonary Medicine, Shaid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Chronic Respiratory Diseases Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

Tanaffos. 2015;14(2):128-33.

Abstract

BACKGROUND

Muscle weakness especially weakness of the respiratory muscles is a complication of chronic kidney disease. The cause of muscle weakness is the accumulation of excessive amounts of urea and other toxins. The aim of this study was to assess the effect of hemodialysis on respiratory muscle strength by measuring maximum inspiratory (PI max) and expiratory pressure (PE max).

MATERIALS AND METHODS

A cross sectional study was carried out on 31 patients with chronic kidney disease at Modarres hospital in 2012. Before hemodialysis, patients had their PI max and PE max taken by using a manovacuometer. After that, the patients were connected to the dialysis machine. At the end of the hemodialysis, the patients had their PI max measured again. Data were assessed by the multivariate regression test.

RESULTS

Before dialysis, PI max and PE max were lower than normal levels. After the hemodialysis session, repeat PFT revealed an increase in PE max and no significant change in PI max. There were strong correlations between hypoalbuminemia, anemia, hypercalcemia, hyperphosphatemia, hyperparathyroidism and decreased respiratory muscle strength. Also, the respiratory muscle strength decreased in the elderly and women.

CONCLUSION

Respiratory muscle weakness is a complication of chronic kidney disease; hemodialysis can improve muscle strength and PI max.

摘要

背景

肌肉无力尤其是呼吸肌无力是慢性肾脏病的一种并发症。肌肉无力的原因是尿素和其他毒素的过量蓄积。本研究的目的是通过测量最大吸气压力(PI max)和最大呼气压力(PE max)来评估血液透析对呼吸肌力量的影响。

材料与方法

2012年在莫达雷斯医院对31例慢性肾脏病患者进行了一项横断面研究。血液透析前,使用压力计测量患者的PI max和PE max。之后,将患者连接到透析机上。血液透析结束时,再次测量患者的PI max。通过多变量回归检验评估数据。

结果

透析前,PI max和PE max低于正常水平。血液透析 session 后,重复肺功能测试显示PE max增加,PI max无显著变化。低白蛋白血症、贫血、高钙血症、高磷血症、甲状旁腺功能亢进与呼吸肌力量下降之间存在强相关性。此外,老年人和女性的呼吸肌力量下降。

结论

呼吸肌无力是慢性肾脏病的一种并发症;血液透析可改善肌肉力量和PI max。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a4d8/4629427/f9e6a2d16f80/Tanaffos-14-128-g001.jpg

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