[摘要】目的采用超声组织定征技术测量尿毒症维持性血液透析(MHD)患者的心肌背向散射积分值，了解MHD患者心肌声学密度特征并探讨贫血对其影响。方法选择透析龄3-6月的MHD患者共45例，30例贫血(男:女20:10 ),15例无贫血(男:女10:5 )，血压均控制稳定。同时设健康对照组15例(男:女10:5)，均接受超声组织定征检测。所有患者随访1年后再次接受超声组织定征检查。随访期间患者血压控制平稳，透析方案无改变。贫血组患者随机分成2组，各15例(男:女10:5),1组经调整红细胞生成素(EPO)等药物后，3月内Hb上升至(109.7514.29) g/L，并基本维持该水平;另1组Hb水平维持在100 g/L以下。非贫血组患者Hb水平保持稳定。结果人选时非贫血组患者心肌平均背向散射积分值(AIB )为6.2110.22，其周期变化幅度(CVIB)为9.88 10.61;贫血组患者AM为8.2010.19 , CVIB为7.8710.51;对照组AM为5.94士。21,CVIB为10.5210.86。随访1年后，贫血纠正组患者AIB及CVIB值得以改善，但与正QNt中华儿童肾病网
常人群仍有显著差异;贫血未纠正组AIB较基础值上升，CVIB较前有下降;非贫血组患者无显著变化。结论透析初期无贫血且血压控制良好的患者，其心肌AIB及CVIB与正常人群相似。贫血是影响尿毒症心肌纤维化的重要因素之一，早期纠正贫血很重要。尿毒症患者一旦发生心肌纤维化，则难以逆转。QNt中华儿童肾病网
　　【关键词】血液透析;超声心动描记术;心肌疾病;贫血QNt中华儿童肾病网
　　Effect of anemia-correction on ultrasonic myocardial integrated backscatter in maintenancehemodialysis patients FANG Yi，DING Xiao-qiang, ZHONG Yi-bong, ZOU Jian-zhou，LIU Shi-zhen，SHU Xian-bong, HUANG Gao-qian. Department of Nephrology，Zhongshan Hospital，FudanUniversity, Shanghai 200032，China　Corresponding author; DING Xiao-qiang.    (Abstract I Objective To measure the ultrasonic backscatter parameters of myocardium inmaintenance hemodialysis (MHD) patients and to evaluate the effects of anemia-correction on thepatients' myocardial properties. Methods Forty-five maintenance hemodialysis patients whose bloodpressure were in good control and 15 healthy volunteers (M: F 10:5) were involved，with 30 anemia(M : F20 :10) and 15 non-anemia (M : F 10:5). With a history of 3 to 6 months maintenancehemodialysis, all the patients undertook echocardiography for ultrasonic tissue characterization at thebeginning of the study and at the end of one-year follow-up. Following the initial echocardiography，anemic patients were randomly divided into two subgroups，one was to correct anemia within the first3 months and to maintain it, the other was to keep a hemoglobin below 100 g/L. Non-anemicpatients maintained their hemoglobin level within the normal range. During the follow-up，all patients'blood pressure were kept in good control in each group. Results At the beginning of the study, thevalue of the average integrated backscatter (AIB) and the cyclic variation of integrated backscatter(CVIB) was 6.2110.22 and 9.8810.61 in non-anemia group，8.2010.19 and 7.87士 0.51 in anemiagroup，5.94士0.21 and 10.52士0.86 in control gourp respectively. After one year's therapy，QNt中华儿童肾病网
　　ultrasonicbackscatter parameters (AIB and CVIB) in anemia-corrected subgroupthe valuessubgroup，were still different fromits AIB was elevated whilethoseCVIBof the control group.As for thewere improved，anenua-uncorrec was reduced compared with the initial values. There was no significant change in non-anemic group. Conclusions Anemic hemodialysis patients have a higherintergrated backscatter value than non-anemic have a similar ultrasonic integrated values to patients，while non-anemic，non一hypertensive patients the healthy people. Anemia may be one of the major factors contributing to myocardial fibrosis in the early stageQNt中华儿童肾病网
　　[Key words] Hemodialysis;Echocardiography;　of cardiomyopathy.　Myocardial disease;AnemiaQNt中华儿童肾病网

　　心脏并发症是尿毒症的重要死亡原因，心肌纤维化是其中的常见类型，但目前临床上缺乏有效的方法来诊断心肌纤维化及评价其严重程度。本研究采用超声组织定征技术(ultrasonic tissue　characterization, UTC )测量维持性Ift液透析早期尿毒症患者和健康人群心肌背向散射积分值(integrated backscatter, IBS)和动态观察其IBS的变化以及贫血对患者心肌声学密度的影响，从而进一步阐明贫血对心肌病变的作用。