• 肺彗星对血液透析患者心功能的评估作用
  • Assessment of heart function by lung comets in maintenance hemodialysis patients
  • 王自良,周长江,许菁,刘伟建.肺彗星对血液透析患者心功能的评估作用[J].内科急危重症杂志,2019,25(5):387-390
    DOI:10.11768/nkjwzzzz20190510
    中文关键词:  心功能  血液透析  肺彗星
    英文关键词:Heart failure  Hemodialysis  Lung comets
    基金项目:
    作者单位
    王自良 济南市人民医院 
    周长江  
    许菁  
    刘伟建  
    摘要点击次数: 50
    全文下载次数: 45
    中文摘要:
          目的: 评估肺彗星对血液透析患者心功能的评估作用。 方法: 选取维持性血液透析患者142例,根据美国心脏病协会(NYHA)心功能分级方法进行分级,142例患者中NYHA分级1~2级66例,3~4级76例,所有患者进行多普勒超声肺部及心脏检测;并检测血常规、生化、超敏C反应蛋白、肿瘤坏死因子水平。结果: NYHA 1~2级组透析龄、血红蛋白、血白蛋白、胆固醇、左室射血分数均高于NYHA 3~4级组;NYHA 1~2级组的平均年龄、透析间〖JP2〗期体重增加、肺彗星数目、肺动脉收缩压、超敏C反应蛋白、肿瘤坏死因子、肌钙蛋白均低于NYHA 3~4级组 (均P<0.05)。多因素logistics回归分析显示肺彗星数目、左室射血分数、透析龄是NYHA独立相关危险因素(均P<0.05)。肺彗星是预示NYHA恶化的独立危险因素(标准化回归系数为8.6662)。结论: 不同心功能分级的血液透析患者出现肺部彗星指数不同,肺彗星是心功能变化的良好标记物,肺彗星对血液透析患者心力衰竭判断有重要作用。
    英文摘要:
          Objective: To assess heart function by lung comets in long-term hemodialys patients . Methods: According to NYHA functional classification, 142 patients receiving hemodialysis were divided into NYHA Class I/II group(66 patients) and the NYHA Class III/IV group(76 patients). All patients were subjected to echocardiography and lung ultrasound. Blood count, clinical biochemistry, high sensitivity C-reactive protein and tumor necrosis factor were detected.Results: Dialysis vintage, hemoglobin, serum albumin, total cholesterol, left ventricular ejection fraction were significantly higher in NYHA Class I/Ⅱ group than in NYHA Class Ⅲ/Ⅳ group ( P<0.05 for all); age was significantly younger, and interdialytic weight gain, lung comets score, pulmonary artery systolic pressure, high sensitivity C-reactive protein, TNF-α , troponin I were significantly lower in NYHA Class I/Ⅱ group than in NYHA Class Ⅲ/Ⅳgroup (P<0.05 for all). The multivariate logistic regression revealed lung comets score, left ventricular ejection fraction, and dialysis vintage were the independent risk factors for NYHA functional class ification (P<0.05 for all). Among all the variables analyzed, lung comets score was a predictor of NYHA progression (standardized estimate= 8.6662). Conclusion: Lung comets scores vary from different heart function classifications. Lung comets are marker of changes in heart function and play an important role in assessing heart failure in hemodialysis patients.