不同基础肾功能水平对心脏再同步化治疗慢性心力衰竭患者短期及长期效果的影响  

Influence of Different Basic Renal Function Levels on Short-term and Long-term Effect of Cardiac Resynchronization Therapy in Patients with Chronic Heart Failure

作　　者：罗承志 朱士彦 李丹妮 江文科 LUO Chengzhi;ZHU Shiyan;LI Danni;JIANG Wenke(The Third Affiliated Hospital of Guangdong Medical University,Foshan 528318,China;不详)

机构地区：[1]广东医科大学附属第三医院佛山市顺德区龙江医院,广东佛山528318

出　　处：《中外医学研究》2021年第16期7-9,共3页CHINESE AND FOREIGN MEDICAL RESEARCH

基　　金：佛山市医学科学技术研究计划项目(20190338)。

摘　　要：目的:观察不同基础肾功能水平对心脏再同步化治疗(CRT)慢性心力衰竭(CHF)患者短期及长期效果的影响。方法:选取2018年10月-2019年11月本院心内科收治66例成功植入CRT-P/D的CHF患者为研究对象,根据肾小球滤过率(GFR)分为A、B、C组,各22例。三组均行CRT。观察治疗前后各组心功能指标、纽约心脏病学会(NYHA)心功能分级及生存情况。结果:术后1、6个月,三组LVEDD、LVESD、LAD和NYHA心功能分级Ⅲ~Ⅳ级占比均较术前显著降低,LVEF较术前显著提高(P<0.05);术后6个月和术后1年,C组LVEDD、LVESD及LAD显著高于A组和B组,LVEF显著低于A组和B组(P<0.05),A组与B组各项指标比较差异无统计学意义(P>0.05)。术后1年内,C组心衰住院率和全因死亡率均明显高于A组和B组,差异有统计学意义(P<0.05)。结论:基础肾功能水平对CRT治疗CHF患者的短期及长期效果影响较大,建议行CRT前,完善患者肾功能评估,以提高治疗效果。Objective:To observe the influence of different basic renal function levels on short-term and long-term effect of cardiac resynchronization therapy(CRT)in patients with chronic heart failure(CHF).Method:From October 2018 to November 2019,66 patients with CHF who were successfully implanted with CRT-P/D in our hospital were selected as the study subjects.According to the glomerular filtration rate(GFR),they were divided into the A,B and C group,22 patients in each group.All three groups were treated with CRT.The cardiac function indexes,New York heart academy(NYHA)cardiac function classification and survival were observed before and after treatment.Result:At 1 and 6 months after operation,the LVEDD,LVESD and LAD proportion of NYHA cardiac function gradeⅢ-Ⅳof the three groups were significantly lower than those before operation,and the LVEF were significantly improved than that before operation(P<0.05).At 6 months and 1 year after operation,the levels of LVEDD,LVESD and LAD in the group C were significantly higher than those in the group A and B,and the LVEF level was significantly lower than that in the group A and B(P<0.05),there were no statistically significant differences in these indexes between the group A and B(P>0.05).Within one year after operation,the hospitalization rate of heart failure and all-cause mortality rate in the group C were significantly higher than those in the group A and group B,the differences were statistically significant(P<0.05).Conclusion:The level of basic renal function has a great influence on the short-term and long-term outcomes of CRT in CHF patients.It is suggested to improve the renal function evaluation of patients before CRT in order to improve the treatment.

关 键 词：基础肾功能水平 慢性心力衰竭 心脏再同步化治疗 短期及长期疗效 

分 类 号：R541.6[医药卫生—心血管疾病]