Hung J, Harris P J, Uren R F, Tiller D J, Kelly D T
N Engl J Med. 1980 Mar 6;302(10):547-51. doi: 10.1056/NEJM198003063021003.
Left ventricular ejection fraction was measured by radionuclide left ventriculography before and immediately after hemodialysis in 20 uremic patients, 11 of whom presented with congestive heart failure. Ejection fraction and contraction were normal in 15 patients (Group A), six of whom had signs of congestive failure; they were abnormal in five patients (Group B), all of whom were in clinical heart failure. Mean arterial pressure and body weight decreased by a similar amount after dialysis in both groups, and heart rate did not change. In Group A ejection fraction was unchanged by dialysis (0.63 +/- before vs. 0.62 +/- 0.09 after) (mean +/- S.D.), but in Group B it was improved significantly (0.32 +/- 0.04 before vs. 0.44 0.08 after) (P less than 0.01). In three patients in Group B cardiomegaly and ejection fraction returned to normal with long-term hemodialysis. In end-state renal failure, radionuclide left ventriculography can separate patients with circulatory congestion due to fluid overload from patients with left ventricular dysfunction in whom hemodialysis can provide immediate and long-term improvement.
对20例尿毒症患者在血液透析前及透析后即刻进行放射性核素左心室造影测量左心室射血分数，其中11例患者有充血性心力衰竭。15例患者（A组）射血分数及收缩功能正常，其中6例有充血性心力衰竭体征；5例患者（B组）射血分数及收缩功能异常，均有临床心力衰竭表现。两组患者透析后平均动脉压及体重下降幅度相似，心率未变。A组透析前后射血分数无变化（透析前0.63±，透析后0.62±0.09）（均值±标准差），但B组射血分数显著改善（透析前0.32±0.04，透析后0.44±0.08）（P＜0.01）。B组3例患者经长期血液透析后心脏扩大及射血分数恢复正常。在终末期肾衰竭患者中，放射性核素左心室造影可将因液体超负荷导致循环充血的患者与左心室功能不全的患者区分开来，后者血液透析可带来即刻及长期的改善。
