血液透析与持续性非卧床腹膜透析：对心脏的影响

Hemodialysis versus continuous ambulatory peritoneal dialysis: effects on the heart.

作者信息

Canziani M E, Cendoroglo Neto M, Saragoça M A, Cassiolato J L, Ramos O L, Ajzen H, Draibe S A

机构信息

Nephrology Division of Escola Paulista de Medicina and Centrocor, São Paulo, Brazil.

出版信息

Artif Organs. 1995 Mar;19(3):241-4. doi: 10.1111/j.1525-1594.1995.tb02321.x.

DOI:10.1111/j.1525-1594.1995.tb02321.x

PMID:7779013

Abstract

In this study we compared the influence of 2 different modalities of treatment, CAPD and hemodialysis, on the prevalence and severity of left ventricular hypertrophy and cardiac arrhythmias of chronic renal failure patients. We compared 27 patients on the CAPD program with 27 patients on the chronic hemodialysis matched for sex, age, and duration of dialysis treatment. The prevalence of hypertension was significantly lower in CAPD than in hemodialysis patient (41% vs. 81%, p = 0.0023). Blood pressure levels were also lower in CAPD than in hemodialysis patients (systolic pressure 124.9 +/- 4.7 vs. 154.8 +/- 4.6 mm Hg, p < 0.0001; diastolic pressure 77.5 +/- 2.9 vs. 93.3 +/- 2.8 mm Hg, p = 0.0001). Left ventricular hypertrophy (LVH) was present in 52% of CAPD and in 93% of hemodialysis patients (p = 0.0008). Severe cardiac arrhythmias (Lown 3-4) occurred in only 4% of CAPD and in 33% of the hemodialysis group (p = 0.0149). The lower frequency of LVH in CAPD might explain the lower incidence of severe arrhythmias.

摘要

在本研究中，我们比较了两种不同治疗方式（持续性非卧床腹膜透析（CAPD）和血液透析）对慢性肾衰竭患者左心室肥厚和心律失常的患病率及严重程度的影响。我们将27例接受CAPD治疗的患者与27例接受慢性血液透析治疗的患者进行了比较，两组患者在性别、年龄和透析治疗时长方面相匹配。CAPD患者的高血压患病率显著低于血液透析患者（41% 对 81%，p = 0.0023）。CAPD患者的血压水平也低于血液透析患者（收缩压 124.9 ± 4.7 对 154.8 ± 4.6 mmHg，p < 0.0001；舒张压 77.5 ± 2.9 对 93.3 ± 2.8 mmHg，p = 0.0001）。52%的CAPD患者存在左心室肥厚（LVH），而血液透析患者中这一比例为93%（p = 0.0008）。严重心律失常（洛恩3 - 4级）仅在4%的CAPD患者中出现，而在血液透析组中为33%（p = 0.0149）。CAPD患者中LVH发生率较低可能解释了严重心律失常发生率较低的原因。