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目的观察尿毒症及血液透析患者的肺功能变化及相关影响因素。方法应用肺功能仪检测49例尿毒症患者(其中19例未透析患者,30例血液透析患者)及30例健康人的肺功能,并就血液透析患者的各项肺功能指标与血红蛋白(Hb)、血清总蛋白(TP)、白蛋白(A)、尿素氮(BUN)、肌酐(Cr)水平进行相关性分析;同时分析患者的肺功能状态与胸片改变的关系。结果尿毒症患者和血液透析患者的用力肺活量%(FVC%)、第1秒用力呼出量%(FEV1%)、用力呼气1 s率%(FEV1/FVC%)、用力呼气中期流速%(FEF25%~75%)、和一氧化碳弥散量%(DLCO%)与健康人比较均有明显下降,差异具有统计学意义(P<0.01)。维持性血液透析患者与未透析尿毒症患者相比肺通气功能、弥散功能有明显改善(P<0.05);患者肺弥散功能的下降与Hb的下降呈直线正相关。结论尿毒症患者的肺功能明显下降,贫血是影响肺弥散功能的原因之一,血液透析治疗及重视纠正贫血有利于改善尿毒症患者的肺功能。
Objective To investigate the changes of pulmonary function and related factors in patients with uremia and hemodialysis. Methods The lung function of 49 cases of uremic patients (19 cases of non-dialysis patients, 30 cases of hemodialysis patients) and 30 healthy people were detected by pulmonary function test. The pulmonary function indexes of hemodialysis patients and hemoglobin (Hb) , Serum total protein (TP), albumin (A), blood urea nitrogen (BUN) and creatinine (Cr) were analyzed. The relationship between lung function status and the changes of chest radiographs was also analyzed. Results FVC%, FEV1%, FEV1 / FVC%, forced expiratory flow rate (%) were significantly higher in uremic patients and hemodialysis patients FEF25% ~ 75%), and% of diffuse carbon monoxide (DLCO%) were significantly decreased compared with healthy people, the difference was statistically significant (P <0.01). Compared with patients without hemodialysis, patients with maintenance hemodialysis had significantly improved pulmonary ventilation and diffusibility (P <0.05). There was a linear positive correlation between decreased pulmonary diffuse function and decreased Hb in patients with maintenance hemodialysis. Conclusions The pulmonary function of patients with uremia is significantly decreased. Anemia is one of the reasons that affect the function of lung diffusion. Hemodialysis treatment and emphasis on correcting anemia are helpful to improve lung function of uremic patients.