连续性肾脏替代治疗联合羟乙基淀粉后置换输入用于伴严重低血压心力衰竭患者的疗效观察  

Effect of CRRT combined with saline hydroxyethyl starch 130/0.4 in refractory heart failure patients with severe hypotension

作　　者：全正莉[1] 任慧敏[1] 郭成坤[1] 杨举红[1] 

机构地区：[1]荆门市第一人民医院肾病内科,湖北荆门448000

出　　处：《临床心血管病杂志》2015年第10期1071-1073,共3页Journal of Clinical Cardiology

摘　　要：目的:观察连续性肾脏替代治疗(CRRT)联合羟乙基淀粉后置换输入用于治疗难治性心力衰竭(心衰)伴严重低血压患者的临床疗效并评估其安全性。方法:42例伴严重低血压的难治性心衰患者,随机分为对照组及试验组。对照组给予单纯CRRT治疗,试验组在CRRT过程中,给予后置换输入羟乙基淀粉130/0.4氯化钠注射液治疗。观察两组患者的心衰症状、左心功能指标(LVEDd、LVESd、SV、VCF、LVEF)、NT-proBNP水平及血压情况,比较两组患者透析血流量、超滤量及透析充分性。结果:对照组总有效率为72.22%,试验组总有效率为83.33%,两组差异具有统计学意义(P<0.05)。两组患者治疗后左心功能各项指标及血浆NT-proBNP水平均优于治疗前(P<0.05),且试验组LVEDd、LVESd、血浆NT-proBN均低于对照组,而SV、VCF、LVEF高于对照组(P<0.05)。试验组血流量、超滤量及透析充分性明显高于对照组(P<0.05),且透析血压改善情况亦优于对照组(P<0.05)。结论:对于伴严重低血压的难治性心衰患者,采用CRRT联合羟乙基淀粉后置换输入具有更稳定的血流动力学、纠正低血压、改善心力衰竭症状及心功能的作用。Objective：To study the effects and safety of CRRT combined with saline hydroxyethyl starch 130/0.4in the treatment of refractory heart failure patients with severe hypotension.Method：Fourty-two patients with refractory heart failure complicated by severe hypotension were randomly divided into treatment group and control group.Patients in treatment group were given CRRT and saline hydroxyethyl starch 130/0.4as post-dilution and those in control group were given CRRT.Between the two groups,comparison and analysis were made on the clinical curative effects and following parameters,including left vertrucular failure parameters,plasma brain natriuretic peptide（BNP）,blood pressures,blood flow volume,ultrafiltration,dialysis adequacy（Kt/V）.Result：The total effective rate of treatment group was 83.33%,and 72.22%in the control group,with the significant difference（P〈0.05）.After treatment,the differences of plasma BNP,LVEDd,LVESd,SV,VCF,LVEF between the two groups were statistically significant（P〈0.05）.Compared with the control group,the dialysis blood flow volume,ultrafiltration in the treatment group was markly increased.The Kt/V in the treatment group was better than that in the control group.The blood pressure of treatment group was significantly higher than that in treatment group（P〈0.05）.Conclusion：CRRT in combinations with saline hydroxyethyl starch 130/0.4have good clinical curative effects and safety in treatment of refractory heart failure patients with severe hypotension.

关 键 词：低血压 难治性心力衰竭 连续性肾脏替代治疗 羟乙基淀粉 

分 类 号：R544.2[医药卫生—心血管疾病]