无创心阻抗法指导老年2型心肾综合征治疗的临床效果观察  

Clinical effect of non-invasive impedance cardiogram therapy in the treatment of elderly patients with type 2 cardio-renal syndrome

作　　者：邵伟华[1] 李伟[2] 李绍冰[1] 姚丽霞[1] 王素星[1] 吕彩霞[1] 王娜 SHAO Wei-hua;LI Wei;LI Shao-bing;YAO Li-xia;WANG Su-xing;LV Cai-xia;WANG Na(Second Division of Geriatrics,Hebei General Hospital,Shijiazhuang 050051,China;First Division of Geriatrics,Hebei General Hospital,Shijiazhuang 050051,China)

机构地区：[1]河北省人民医院老年病二科,河北省石家庄市050051 [2]河北省人民医院老年病一科,河北省石家庄市050051

出　　处：《实用老年医学》2020年第9期947-950,共4页Practical Geriatrics

基　　金：河北省中医药管理局课题(2018074)。

摘　　要：目的评价无创心阻抗法(ICG)指导老年2型心肾综合征(CRS)病人临床治疗的效果。方法收集符合纳入标准的老年2型CRS病人58例,随机分为对照组及ICG组,每组各29例,2组均按照现行指南给予抗心衰、保肾等内科治疗,ICG组应用无创心阻抗监测仪指导调整治疗方案;测定2组治疗前后N端脑钠肽前体(NT-proBNP)、左室流出道速度时间积分(VTI)、LVEF、血BUN、血清胱抑素C(CysC)、估算肾小球滤过率(eGFR)、尿量的变化,并比较2组临床治疗总有效率。结果治疗后,2组病人NT-proBNP、BUN、CysC水平均较治疗前下降,VTI、LVEF、eGFR、尿量较治疗前升高,差异均有统计学意义(P<0.05);ICG组上述指标水平变化较对照组更明显,差异均有统计学意义(P<0.05)。ICG组临床总有效率明显高于对照组(χ^2=11.485,P<0.001)。结论ICG指导老年2型CRS治疗,能及时、准确地反映病人治疗过程中的血流动力学指标变化,明显提高老年2型CRS的治疗有效率,具有较强的实用价值,适合临床推广。Objective To evaluate the value of non-invasive impedance cardiogram(ICG)in the treatment of elderly patients with type 2 cardio-renal syndrome(CRS).Methods Fifty-eight elderly patients with type 2 CRS were randomly divided into the control group and the ICG group,with 29 cases in each group.The two groups were given anti-heart failure and kidney protection treatment according to the current guidelines.The ICG group used non-invasive cardiac impedance monitor to guide the adjustment of treatment plan.The levels of N-terminal brain natriuretic peptide precursor(NT-proBNP),left ventricular outflow tract velocity time integral(VTI),left ventricular ejection fraction(LVEF),blood urea nitrogen(BUN),serum cystatin C(CysC),evaluated glomerular filtration rate(eGFR),and urine output before and after treatment were detected and compared between the two groups.The total effective rate of clinical treatment was recorded in the two groups.Results After treatment,the levels of NT-proBNP,BUN,and CysC of the two groups were all lower than those before treatment,and the levels of VTI,LVEF,eGFR and urine volume were higher than those before treatment in both groups,especially in the ICG group(P<0.05).The total clinical effective rate of the ICG group was significantly higher than that of the control group(93.10%vs 82.76%,P<0.001).Conclusions ICG method can reflect the changes of hemodynamic indexes in the treatment process of type 2 CRS timely and accurately,and significantly improve the clinical treatment efficiency of elderly patients with type 2 CRS.

关 键 词：无创心阻抗法 老年人 心肾综合征 

分 类 号：R541[医药卫生—心血管疾病]