中文摘要：

目的观察高通量血液透析（HFHD）对尿毒症患者心功能的影响。方法采用前瞻性随机对照研究方法，选择2014年12月至2015年6月贵阳市第二人民医院收治的确诊为尿毒症并需维持性血液透析（MHD）治疗的60例患者和30例健康体检者。按随机数字表法将患者分为HFHD组（每周3次）和普通血液透析（HD）组（每周3次），每组30例；另外，所有患者每月均接受1次血液灌流（HP）和1次血液滤过（HF）治疗。所有患者于治疗前及治疗6个月取静脉血，检测血清B型脑钠肽（BNP）、心肌肌钙蛋白T（cTnT），并由专人进行心脏B超检查，记录左室舒张期末内径（LVEDD）、左室收缩期末内径（LVESD）、左室舒张期末容积（LVEDV）、左室收缩期末容积（LVESV）、左室后壁厚度（LVPWT）、室间隔厚度（IVST）、舒张早期与晚期最大血流比（E/A）、左室射血分数（LVEF）、左室重量指数（LVMI）。结果与健康对照组比较，HD组和HFHD组治疗前BNP、cTnT、LVEDD、LVESD、LVESV、LVPWT、IVST均显著升高，LVEDV显著下降；而HD组与HFHD组上述各指标及E/A、LVEF、LVMI比较差异均无统计学意义。与治疗前比较，HD组治疗后BNP、LVPWT显著降低〔BNP（ng/L）：641.50±60.09比2？676.20±454.30，LVPWT（mm）：10.57±1.16比12.57±1.41，均P〈0.05〕；HFHD组治疗后BNP、LVPWT下降较HD组更为显著〔BNP（ng/L）：253.10±48.77比641.50±60.09，LVPWT（mm）：9.29±1.08比10.57±1.16，均P〈0.05〕，另外HFHD组治疗后cTnT、IVST、LVMI较治疗前显著降低〔cTnT（μg/L）：0.014±0.005比0.028±0.011，IVST（mm）：7.81±1.69比11.04±2.23，LVMI（g/m2）：149.10±15.77比158.70±17.25，均P〈0.05〕，LVEF显著升高（0.574±0.068比0.528±0.082，P〈0.05）。结论HFHD改善尿毒症患者心功能较普通HD有明显优势。

英文摘要：

ObjectiveTo investigate the effects of high flow hemodialysis （HFHD） on cardiac function in uremia patients.MethodsA prospective randomized controlled study was conducted. Sixty patients who were diagnosed with uremia, taken maintenance hemodialysis （MHD） and 30 healthy controls admitted to the Second People＇s Hospital of Guiyang from December 2014 to June 2015 were enrolled. They were randomly divided into two groups： HFHD group （HFHD three times a week） and the routine hemodialysis group （HD group, HD three times a week）, with 30 in each group. Patients in each group were received hemoperfusion and hemofiltration once a month. Before the treatment and 6 months after the treatment, venous blood from all the patients were collected for testing the brain natriuretic peptide （BNP）, cardiac troponin T （cTnT） and the ultrasound cardiograph were done at the same period by a special person, the left ventricular end diastolic diameter （LVEDD）, left ventricular end systolic diameter （LVESD）, the left ventricular end diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV）, left ventricular posterior wall thickness （LVPWT）, interventricular septum thickness （IVST）, early and late diastolic blood flow to the largest ratio （E/A）, left ventricular ejection fraction （LVEF）, left ventricular mass index （LVMI） were recorded.ResultsCompared with the health control group, BNP, cTnT, LVEDD, LVESD, LVESV, LVPWT, IVST were significantly increased, LVEDV were significantly lowered before treatment in the HD group and HFHD group. But no significant differences in the above indexes and E/A, LVEF, LVMI between two groups were found. Compared with the data before treatment, the BNP, LVPWT were significantly lowered after treatment in HD group [BNP （ng/L）： 641.50±60.09 vs. 2676.20±454.30, LVPWT （mm）： 10.57±1.16 vs. 12.57±1.41, both P 〈 0.05]. The BNP, LVPWT were significantly lowered in HFHD group as compared with HD group [BNP （ng/L）： 25