新活素联合CRRT治疗急性心力衰竭并发急性肾衰竭的疗效观察  

Observation on the Clinical Efficacy of rh-BNP plus CRRT on the Acute Heart Failure Combined with Acute Renal Failure

作　　者：魏薇[1] 高岩[1] 毕宏远[1] 翟哲[1] 王鹏[1] 刘小伟[1] 杜纯鹏[1] 吴鹏[1] 

机构地区：[1]哈尔滨医科大学附属第四医院重症医学科,黑龙江哈尔滨150001

出　　处：《现代生物医学进展》2013年第17期3285-3288,共4页Progress in Modern Biomedicine

基　　金：黑龙江省科技计划项目(GC09C408-3)

摘　　要：目的:观察新活素联合连续性肾脏替代治疗(continuous renal replacement therapy,CRRT)治疗急性心力衰竭并发急性肾衰竭的临床疗效。方法:选择2011年9月至2012年9月于我院ICU治疗的36例急性心力衰竭并发急性肾衰竭的患者,并将其随机分为3组,分别给予新活素联合CRRT治疗、单独新活素治疗、单独CRRT治疗,比较治疗前后各组患者的Killip分级、左心室射血分数、尿量、BNP、血肌酐及尿素氮、氧合指数、动脉血乳酸值的变化情况。结果:观察组的显效率、有效率及总体有效率均较对照组1和对照组2显著降低,差异均具有显著统计学意义(P<0.01),对照组1的显效率及总体有效率均明显高于对照组2(P<0.01),但两组患者的有效率比较无统计学差异(P>0.05)。观察组治疗7天的死亡率明显低于对照组1和对照组2,差异均有显著性(P<0.01)。观察组及对照组2的心肾功能指标均较治疗前明显改善(P<0.01),且观察组的改善程度明显优于对照组2(P<0.01),对照组1的心功能指标较治疗前明显改善(P<0.01),但肾功能指标无明显变化(P>0.05),但尿量显著增加(P<0.01)。结论:新活素联合CRRT治疗组疗效明显优于单独CRRT或新活素治疗组,并可有效降低患者的死亡率。Objective： To observe the clinical efficacy of rh-BNP joint continuous renal replacement therapy（CRRT） in the treatment of acute heart failure combined with acute renal failure.Methods： 36 patients of acute heart failure combined with acute renal failure hospitalized from September 2011 to September 2012 at the ICU of our hospital were randomly divided into three groups,and were separately given rh-BNP joint CRRT,rh-BNP and CRRT.The change of the Killip classification,left ventricular ejection fraction,urine output,BNP,serum creatinine and blood urea nitrogen,oxygenation index,arterial blood lactate value of all the groups before and after treatment were compared.Results： The efficiency rate,effective rate and overall efficiency rate of the control group 1 and 2 were significantly increased（P0.01）,but the efficiency rate and overall efficiency rate of control group 1 were significantly higher than those of the control group 2（P0.01）.No significant difference of the efficient rate was found between the two groups（P0.05）.The 7-day mortality of observation group was obviously lower than those of the two control groups（P0.01）.All the obvervational index of observation group and control group 2 were obviously improved than before treatment（P0.01）,which were more obvious in the observation group than the control group 2（P0.01）;the cardiac function indicators of control group 1 were obviously improved than before treatment（P0.01）,but no significant difference of kidney function was found than before treatment（P0.05）.Conclusion： Rh-BNP joint CRRT were significantly better than single CRRT or rh-BNP in the treatment of acute heart failure complicated by acute renal failure,and effectively reduced the mortality of patients.

关 键 词：急性心力衰竭 急性肾衰竭 重组人脑钠肽 连续性肾脏替代治疗 B型脑钠肽 

分 类 号：R541.61[医药卫生—心血管疾病] R692.5[医药卫生—内科学]