CVVHDF与CVVH改善尿毒症合并急性心力衰竭患者肌钙蛋白的对照研究  

Comparative study of CVVHDF and CVVH in improving troponin in patients with uremia complicated with acute heart failure

作　　者：李晓雷[1] 刘星[1] 赵丹[1] 江鹏[1] LI Xiaolei;LIU Xing;ZHAO Dan;JIANG Peng(Southern Medical University Shenzhen Hospital,Shenzhen 518101,China)

机构地区：[1]南方医科大学深圳医院,广东深圳518101

出　　处：《中国医药科学》2017年第15期233-235,247,共4页China Medicine And Pharmacy

摘　　要：目的通过对心肌酶谱变化的监测,同时通过对治疗前后患者APACHEⅡ评分进行比较,研究CVVHDF和CVVH治疗对改善尿毒症合并急性心力衰竭患者心肌损伤的疗效分析。方法将尿毒症合并急性心衰患者分为两组,一组进行CVVH治疗,另一组进行CVVHDF治疗,通过监测患者肌钙蛋白的变化,评估患者心肌损伤的恢复状况,并在治疗前后进行APACHEⅡ评分。结果 CVVH组和CVVHDF组治疗后都能很好的稳定患者生命体征,但CVVHDF组较CVVH组能更好的降低肌钙蛋白T以及肌钙蛋白Ⅰ指标,且CVVHDF组能更显著降低患者APACHEⅡ评分,显著改善患者预后。结论 CVVHDF可以更好的保护受损心肌,改善患者心力衰竭状况。Objective Through monitoring the changes of myocardial zymogram,and through comparing the score ofthe APACHEⅡscores of patients before and after treatment,to investigate the efficacy of CVVHDF and CVVH in thetreatment of myocardial injury in patients with uremia complicated with acute heart failure.Methods The patientswith uremia complicated with acute heart failure were divided into two groups,one group received CVVH treatment,andthe other group received CVVHDF treatment.The recovery of myocardial injury was assessed by monitoring changesin troponin levels and APACHEⅡscores were measured before and after treatment.Results Both the CVVH andCVVHDF groups were able to stabilize the patient's vital signs after treatment,but the CVVHDF group can betterreduce the troponin T and troponinⅠindex than the CVVH group,and the CVVHDF group could significantly reducethe APACHE andⅡscores and significantly improve the prognosis of the patients.Conclusion CVVHDF can betterprotect damaged myocardium and improve heart failure.

关 键 词：尿毒症 心衰 连续性静静脉血液滤过 连续性静静脉血液滤过透析 心肌酶谱 

分 类 号：R541.6[医药卫生—心血管疾病]