持续性血液净化治疗顽固性心力衰竭73例疗效观察

张丽琴; 邢昌赢; 蒋艺萍; 解林花

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持续性血液净化治疗顽固性心力衰竭73例疗效观察

张丽琴 , 邢昌赢 , 蒋艺萍 , 解林花

文章导航 > 蚌埠医学院学报 > 2013, 37 > 12: (1590-1592)

引用本文:

Citation:

持续性血液净化治疗顽固性心力衰竭73例疗效观察

1.
1. 南京医科大学附属淮安第一医院肾内科, 江苏淮安 223300;
2.
2. 江苏省人民医院肾内科, 江苏南京 210029

作者简介: 张丽琴(1971－ ),女,副主任医师.

通讯作者: 邢昌赢, cyxing62@126.com ;

基金项目:

The effect of continuous blood purification in the treatment of refractory heart failure in 73 cases

1.
1. Department of Nephrology, The First Hospital of Huaian Affiliated of Nanjing Medical University, Huaian Jiangsu 223300;
2.
2. Department of Nephrology, The People's Hospital of Jiangsu Province, Nanjing Jiangsu 210029, China

Corresponding author: XING Chang-ying, cyxing62@126.com ;

摘要: 目的:探讨持续性血液净化(CBP)治疗顽固性心力衰竭(心衰)的效果。方法:顽固性心衰患者114例,73例接受常规心衰药物及CBP治疗(CBP组),41例接受常规心衰药物治疗(常规组)。比较2组患者治疗后生化指标、心功能及治疗转归情况。结果:CBP组治疗后血钠、血钾、血肌酐、尿素氮、B型脑钠肽水平均较常规组明显改善(P0.01);心率、收缩压、舒张压、左心室射血分数、心脏指数、左心室舒张末内径及24 h尿量的改善效果也均明显优于常规组(P0.01);CBP组心功能分级改善情况显著优于常规组(P0.01)。治疗期间病死率明显低于常规组(P0.01)。结论:与单独使用常规药物治疗相比,CBP能显著改善顽固性心衰患者临床生化指标,增强患者心功能,改善预后。
- 心力衰竭 /
- 血液净化 /
- 心功能
Abstract: Objective: To investigate the effects of continuous blood purification( CBP) in the treatment of refractory heart failure. Methods: One hundred and fourteen patients with refractory heart failure were divided into CBP group treated with CBP therapy( 73 cases) and conventional group treated with conventional heart failure drugs( 41 cases). The biochemical index,heart function and clinical outcome in two groups were compared after treatment. Results: The levels of serum sodium,potassium,creatinine,urea nitrogen and B-type brain natriuretic peptide in CBP group were significantly better than those in conventional group( P 0. 01). Compared with the conventional group,the levels of heart rate,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,cardiac index,left ventricular end-diastolic diameter and 24 h urine in CBP group were significantly improved( P 0. 01). The improvement of cardiac functional grading in CBP group was significantly better than that in conventional group( P 0. 01). The mortality of CBP group was significantly lower than that in conventional group during treatment( P 0. 01). Conclusions: Compared with the conventional heart failure drugs treatment,the CBP treatment can significantly improve the biochemical markers and prognosis,enhance the heart function of patients with refractory heart failure.
- refractory heart failure /
- continuous blood purification /
- heart function

[1]	李新建,靳维华,张斌. 顽固性心衰治疗进展[J]. 中国心血管病研究,2009,7(3):226-229.
[2] 温德良,刘卫江,古英明,等. 连续性血液净化治疗重症心力衰竭合并肾衰竭患者的疗效分析[J]. 中国血液净化,2008,7(5):260-262.
[3] 郑珍香,叶光福,吴志雄,等. 持续静- 静脉血液滤过治疗妊娠高血压疾病合并急性左心衰竭的疗效及安全性研究[J].中国血液净化,2010,9(4):198-201.
[4] Willenheimer R,van Veldhuisen DJ,Ponikowski P,et al. CIBIS-Ⅱ stering committe and investigators:-blocker treatment before angiotensin-converting enzyme inhibitor therapy in newly diagnosed heart failure[J]. J Am Coil Cardiol,2005,46 (1):182.
[5] Cleland JG,Coletta AP,Lammiman M,et al. Clinical trials update from the European society of cardiology meeting 2005:CARE-HF extension study.ESSENTIAL,CIBIS-Ⅲ,SICD,ISSUE-2,STRIDE-2,SOFA,IMAGlNE,PRE-AMI,SIRIUS-Ⅱand ACTIVE[J]. Eur J Heart Fail,2005,7(6): 1070-1075.
[6] 王华兵,曾艳,曾和松,等. 连续性血液净化在难治性心力衰竭中的治疗观察[J]. 中国医师进修杂志,2010,33 (19):60-62.
[7] 玉宝,史忠. 连续性肾脏替代治疗(cRRT) 的临床治疗进展[J]. 重庆医学,2007,36(18):1823-1824.
[8] 李桂芹,赵少华. 持续血液净化治疗顽固性心衰疗效观察[J]. 中国实用医药,2011,6(13):123-124.
[9] 胡北平,汪永斌. 连续性静脉血液滤过治疗顽固性心力衰竭 24 例[J]. 浙江实用医学,2009,14(1):28-75.
[10] 黄洁平,邓行江,何建发,等. 连续性血液净化治疗顽固性心力衰竭和清除炎症介质临床研究[J]. 中国血液净化,2011,10(4):201-203.
[11] Salvatori G,Ranco F,Ronello M,et al. Management of fluid overload in congestive heart failure:learning from a case report[J]. Int J Artfi Org,2006,29(2):187.

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持续性血液净化治疗顽固性心力衰竭73例疗效观察

通讯作者: 邢昌赢, cyxing62@126.com;

作者简介: 张丽琴(1971－ ),女,副主任医师.

1. 1. 南京医科大学附属淮安第一医院肾内科, 江苏淮安 223300;
2. 2. 江苏省人民医院肾内科, 江苏南京 210029

收稿日期: 2013-01-26
网络出版日期: 2013-12-15

基金项目:

关键词:

摘要: 目的:探讨持续性血液净化(CBP)治疗顽固性心力衰竭(心衰)的效果。方法:顽固性心衰患者114例,73例接受常规心衰药物及CBP治疗(CBP组),41例接受常规心衰药物治疗(常规组)。比较2组患者治疗后生化指标、心功能及治疗转归情况。结果:CBP组治疗后血钠、血钾、血肌酐、尿素氮、B型脑钠肽水平均较常规组明显改善(P0.01);心率、收缩压、舒张压、左心室射血分数、心脏指数、左心室舒张末内径及24 h尿量的改善效果也均明显优于常规组(P0.01);CBP组心功能分级改善情况显著优于常规组(P0.01)。治疗期间病死率明显低于常规组(P0.01)。结论:与单独使用常规药物治疗相比,CBP能显著改善顽固性心衰患者临床生化指标,增强患者心功能,改善预后。

English Abstract

The effect of continuous blood purification in the treatment of refractory heart failure in 73 cases

Corresponding author: XING Chang-ying, cyxing62@126.com

1. 1. Department of Nephrology, The First Hospital of Huaian Affiliated of Nanjing Medical University, Huaian Jiangsu 223300;
2. 2. Department of Nephrology, The People's Hospital of Jiangsu Province, Nanjing Jiangsu 210029, China

Received Date: 2013-01-26
Available Online: 2013-12-15

Abstract: Objective: To investigate the effects of continuous blood purification( CBP) in the treatment of refractory heart failure. Methods: One hundred and fourteen patients with refractory heart failure were divided into CBP group treated with CBP therapy( 73 cases) and conventional group treated with conventional heart failure drugs( 41 cases). The biochemical index,heart function and clinical outcome in two groups were compared after treatment. Results: The levels of serum sodium,potassium,creatinine,urea nitrogen and B-type brain natriuretic peptide in CBP group were significantly better than those in conventional group( P 0. 01). Compared with the conventional group,the levels of heart rate,systolic blood pressure,diastolic blood pressure,left ventricular ejection fraction,cardiac index,left ventricular end-diastolic diameter and 24 h urine in CBP group were significantly improved( P 0. 01). The improvement of cardiac functional grading in CBP group was significantly better than that in conventional group( P 0. 01). The mortality of CBP group was significantly lower than that in conventional group during treatment( P 0. 01). Conclusions: Compared with the conventional heart failure drugs treatment,the CBP treatment can significantly improve the biochemical markers and prognosis,enhance the heart function of patients with refractory heart failure.