老年心瓣膜病所致顽固性心力衰竭短期血液透析治疗  

Hemodialysis as Short-term Treatment for Refractory Heart Failure in Aged Patients with Cardiac Valve Disease

作　　者：纪义国[1] 王晏平[2] 王旭[2] 邹作君[2] 

机构地区：[1]山东省青岛市急救中心,266101 [2]青岛市市立医院

出　　处：《中国微循环》2005年第6期439-441,共3页Journal of Chinese Microcirculation

摘　　要：目的探讨血液透析对老年心瓣膜病顽固性心衰的治疗作用,从而寻找一种治疗老年顽固性心衰的较有效的治疗手段。方法研究26例老年心瓣膜病顽固性心衰患者在血液透析前后的临床表现及血生化,神经内分泌指标的变化。结果血液透析可使老年心瓣膜病顽固性心衰患者的病死率由100%下降至58.93%(P<0.01),结合手术可明显提高存活率及存活质量。短期血液透析可在短期内改善及纠正老年顽固性心衰患者血浆恶化的K+,Na+,C l-,BUN,Cr,白蛋白及去甲肾上腺素(NE),肾上腺素(E),血浆肾素活性(PRA),血管紧张素II(AII)和醛固酮(ALD)的水平。结论血液透析可在短期内改善老年心瓣膜病顽固性心衰患者的临床状况及心功能,明显降低老年瓣膜病顽固性心衰患者的病死率。Objective To explore therapeutic effect of hemodialysis on refractory heart failure in aged patients with cardiac valvular disease to seek an effective method of treating refractory heart failure. Methods Clinical manifestation and changes of blood biochemistry, neuroendocrine index were investigated before and after hemodialysis in 26 cases of aged patients with valvular disease secondary to refractory heart failure. Results The study showed that hemodialysis of refractory heart failure in aged patients with cardiac valvular disease could reduce mortality remarkably from 100% to 58.93% （P 〈 0.01）. Combination with operation could increase survival rate and qnility obviously. Short-term hemodialysis could improve and correct deteriorative plasma levels of sodium ion （ Na^＋）, potassium ion （ K^＋）, chlorine ion （ CL^-）, blood urea nitrogen（BUN）, creatinine（Cr）, albumen and plasma noradrenaline（NE）, adrenaline（E）, plasma renin activity（PRA）, plasma angiotensinⅡ（AⅡ） and plasma aldosterone（ALD） in aged patients with refractory heart failure within short time with the improvement of blood. Conclusion Our data show that hemodialysis could improve these aged patient＇s cardiac function and clinical condition within short time and could reduce their mortality remarkably.

关 键 词：血液透析 老年心瓣膜病 顽固性心衰 

分 类 号：R542.5[医药卫生—心血管疾病] R541.6[医药卫生—内科学]