缬沙坦对维持性血液透析患者心脏功能和结构的影响

目的:探讨缬沙坦对维持性血液透析(maintenance hemodialysis,MHD)患者心脏功能和结构的影响。方法:100例MHD患者,随机分为治疗组(50例)与对照组(50例),对照组仅予基础治疗,治疗组加予口服缬沙坦治疗,总疗程为6个月。观察治疗前后超声心动图指标变化。结果:与治疗前及对照组同期比较,治疗组心脏结构指标左房收缩末期内径(LAD)、左室舒张末期内径(LVDD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左房内径指数(LAI)、左室重量指数(LVMI)及相对室壁厚度(RWT)有所降低,心脏功能指标:左室射血分数(LVEF),左室短轴缩短率(FS),二尖瓣口舒张早期和晚期最大血流速度比(E/A)值有所提高,差异均有统计学意义(P<0.05)。对照组超声心动图各项指标与治疗前相比变化不明显(P>0.05)。结论:缬沙坦能延缓或逆转左心室肥厚,明显改善左室舒张功能,有助于改善MHD患者心脏重构,改善心脏功能,从而延缓慢性肾功能衰竭尿毒症期患者的左心室重塑,降低心血管疾病的发生率和死亡率。缬沙坦对MHD患者心血管疾病并发症的预防和治疗及提高MHD患者生存率有一定临床指导意义。

Effect of Valsartan on Cardiac Function and Structure in MaintenanceHemodialysis Patients

Objective: To study valsartan on maintenance hemodialysis(MHD) patients with cardiac function and structure.Methods: Totally 100 MHD patients were randomized into valsartan and control groups.Patients in the valsartan group were given 80mg valsartan per day for six months.Before and after the treatment,echocardiography index were detected and the data were statistically analyzed through SPSS16.0.Results: After 6 months,MHD patients with the treatment group cardiac structure indicators: left atrial end systolic diameter(LAD),left ventricular end diastolic diameter(LVED),interventricular septum diastolic thickness(IVST),left ventricular posterior wall diastolic thickness(LVPWT),left atrial diameter index(LAI),left ventricular mass index(LVMI),relative wall thickness(RWT) values were significantly lower than the control group,the difference was significant(P <0.05).Indicators of cardiac function: left ventricular ejection fraction(LVEF),left ventricular fractional shortening(FS),mitral early and late diastolic peak velocity ratio(E/A) values were significantly higher than the control group(P< 0.05),with statistical significance.Conclusions: Valsartan can improve cardiac function and structure in MHD patients,and maybe contribute to the prevention and treatment of cardiovascular complications in MHD patients.