Ulmer H E, Griener H, Schüler H W, Schärer K
Acta Paediatr Scand. 1978 Jan;67(1):43-8. doi: 10.1111/j.1651-2227.1978.tb16275.x.
Forty children with chronic renal failure (CRF) on conservative treatment, on hemodialysis, or after renal transplantation and 22 children respresenting a non-uremic control group were subjected to repeated cardiologic examinations by ECG, PCG, chest X-rays and cycle ergometer exercise tests to monitor signs of uremic heart disease and to evaluate physical working capacity (W170). In the CRF group a progressive impairment of W170 was found, starting at an early stage of the disease. Exercise tolerance was inversely related to the degree of CRF. A correlation was also found between W170 and renal anemia. After starting dialysis, W170 failed to increase significantly. Immediately after dialysis an acute drop in W170 occurred. Renal anemia was found to be the main pathogenetic factor of uremic heart disease in children. In some cases hypercirculation following arteriovenous fistulae became equally important as a cause of reduced myocardial performance. Physical rehabilitation, as measured by exercise tolerance tests, was better in transplanted than in dialysed children.
对40名接受保守治疗、血液透析或肾移植的慢性肾衰竭（CRF）儿童以及22名代表非尿毒症对照组的儿童进行了反复的心脏检查，包括心电图、心音图、胸部X光和自行车测力计运动试验，以监测尿毒症性心脏病的体征并评估体力工作能力（W170）。在CRF组中，发现从疾病早期开始W170就有进行性损害。运动耐量与CRF程度呈负相关。还发现W170与肾性贫血之间存在相关性。开始透析后，W170未能显著增加。透析后立即出现W170急性下降。肾性贫血被认为是儿童尿毒症性心脏病的主要致病因素。在某些情况下，动静脉瘘后的高循环状态成为心肌功能降低的同等重要原因。通过运动耐量测试衡量，移植儿童的身体康复情况优于透析儿童。
