肾移植对儿童和成人心脏形态及功能特征的影响。

Impact of renal transplantation on cardiac morphological and functional characteristics in children and adults.

作者信息

El-Khashab Sahier Omar, Mohamed Eman El-Sayed, Soliman Mahmoud A, Kassem Hussein Heshmat, Soliman Amin Roshdy

机构信息

Sahier Omar El-Khashab, Eman El-Sayed Mohamed, Amin Roshdy Soliman, Department of Nephrology, Kasr Al-Ainy Cairo University, Cairo 11451, Egypt.

出版信息

World J Nephrol. 2016 Nov 6;5(6):517-523. doi: 10.5527/wjn.v5.i6.517.

DOI:10.5527/wjn.v5.i6.517

PMID:27872833

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5099597/

Abstract

AIM

To compare the effects of renal transplantation on cardiac functions in children and adults.

METHODS

One hundred and ten patients attending the nephrology outpatient clinic were enrolled in this study and were divided into six groups. The first two groups consisted each of 30 renal transplant patients who had a successful renal transplantation more than six months, but less than one year. Group I were less than 18 years and group II were more than 18 years. The third and fourth groups, each were 20 chronic renal failure patients on regular hemodialysis. Again, group III were less than 18 years and group IV were more than 18 years. Group V and VI (The control Groups) consisted each of 5 subjects below and above 18 years of age, respectively with normal kidney functions. All patients were subjected to history and examination. The kidney functions and the hemoglobin were analyzed. After obtaining informed consent, echocardiography was done to all patients.

RESULTS

There was a statistically significant improvement ( < 0.0001) in all cardiac parameters. A regression in left ventricular end diastolic volume (LVED) both in children (4.7 ± 0.8 to 4.2 ± 0.5) and in adults (5.9 ± 0.7 to 4.9 ± 0.6) were found. There was a regression in left ventricular end systolic volume (LVES) both in children (3.1 ± 0.6 to 2.4 ± 0.4) and in adults (4.1 ± 0.9 to 3.1 ± 0.5). Fractional shortening improves both in children (32.6 ± 5.3 to 41.7 ± 7.6) and in adults (29.0 ± 6.6 to 36.5 ± 4.1). The improvement in ejection fraction (EF) was higher in children (59.7 ± 7.0 to 71.9 ± 6.1) than in adults (52.0 ± 12.5 to 64.8 ± 5.9). However, this degree of improvement (in children: 12.2 ± 5.1) did not show statistical difference (-value 0.8), when compared to adults (12.7 ± 9.8).

CONCLUSION

After renal transplantation cardiac functions and morphology (EF/LVED/LVES) do improve markedly and rapidly in both children and adults.

摘要

目的

比较肾移植对儿童和成人心脏功能的影响。

方法

本研究纳入了110名肾病门诊患者，并将其分为六组。前两组各有30名肾移植成功且时间超过6个月但不到1年的患者。第一组年龄小于18岁，第二组年龄大于18岁。第三组和第四组各有20名接受定期血液透析的慢性肾衰竭患者。同样，第三组年龄小于18岁，第四组年龄大于18岁。第五组和第六组（对照组）分别各有5名年龄在18岁以下和18岁以上且肾功能正常的受试者。所有患者均接受病史询问和检查。分析肾功能和血红蛋白。在获得知情同意后，对所有患者进行了超声心动图检查。

结果

所有心脏参数均有统计学意义的改善（<0.0001）。发现儿童（从4.7±0.8至4.2±0.5）和成人（从5.9±0.7至4.9±0.6）的左心室舒张末期容积（LVED）均有所下降。儿童（从3.1±0.6至2.4±0.4）和成人（从4.1±0.9至3.1±0.5）的左心室收缩末期容积（LVES）均有所下降。儿童（从32.6±5.3至41.7±7.6）和成人（从29.0±6.6至36.5±4.1）的缩短分数均有所改善。儿童的射血分数（EF）改善程度（从59.7±7.0至71.9±6.1）高于成人（从52.0±12.5至64.8±5.9）。然而，与成人（12.7±9.8）相比，这种改善程度（儿童：12.2±5.1）未显示出统计学差异（-值0.8）。