床旁肾脏替代治疗对心肾综合征患者疗效及短期预后的影响分析  

Effects of bedside renal replacement therapy on the efficacy and short-term prognosis of patients with cardiorenal syndrome

作　　者：戴芳 刘伯英 江明宏 臧立会 吴新梅 Dai Fang;Liu Boying;Jiang Minghong;Zang Lihui;Wu Xinmei(不详;Army 82nd Group Military Hospital,Baoding 071000,China)

机构地区：[1]陆军第八十二集团军医院,保定071000 [2]保定市第一中医院,保定071000

出　　处：《中国循证心血管医学杂志》2022年第6期711-713,720,共4页Chinese Journal of Evidence-Based Cardiovascular Medicine

基　　金：河北省保定市科学技术局科研计划项目(2041ZF339)。

摘　　要：目的分析床旁肾脏替代治疗对心肾综合征患者疗效及短期预后的影响。方法选择我院自2018年1月至2020年1月就诊的144例心肾综合征患者作为研究对象,随机分为对照组和观察组各72例。对照组予以常规治疗,观察组在对照组的基础上,予以床旁肾脏替代治疗。比较两组治疗前后的血清肌酐(Scr)、血尿素氮(BUN)、血红蛋白(Hb)、白蛋白(ALB)、血清总蛋白(TP)、N末端脑钠肽前体(NT-proBNP)、左室射血分数(LVEF)、左室舒张末内径(LVED)、心率(HR)、平均动脉压(MAP)、白细胞介素-8(IL-8)、白细胞介素-10(IL-10)、肿瘤坏死因子α(TNF-α)、白细胞介素-1β(IL-1β)。随访12个月,比较两组的尿毒症发生率、主要心血管事件发生率和存活率。结果观察组治疗后Scr、BUN水平均低于对照组,差异均有统计学意义(P<0.05);观察组治疗后BNP水平低于对照组,HR明显慢于对照组(P<0.05);观察组治疗后血清IL-8、TNF-α、IL-1β水平均低于对照组,IL-10水平明显高于对照组(P<0.05);两组均无院内死亡病例,在尿毒症发生率、主要心血管事件发生率、存活率上,差异不大,无明显统计学意义(P>0.05)。结论床旁肾脏替代治疗能改善心肾综合征患者的心肾功能,清除炎症因子,但对短期预后影响不大,值得进一步研究应用。Objective To analyze the effects of bedside renal replacement therapy on the efficacy and short-term prognosis of patients with cardiorenal syndrome.Methods A total of 144 patients with cardiorenal syndrome admitted to our hospital from January 2018 to January 2020 were selected as the research subjects and randomly divided into control group and observation group,with 72 cases in each group.The control group was given routine treatment,and the observation group was given bedside renal replacement therapy on the basis of the control group.Comparison of two groups before and after treatment,serum creatinine(Scr),blood urea nitrogen(BUN),haemoglobin(Hb),albumin(ALB),serum total protein(TP),NT-pro brain natriuretic peptide(NT-proBNP)and left ventricular ejection fraction(LVEF),left ventricular end-diastolic diameter(LVED),heart rate(HR),mean arterial pressure(MAP),interleukin-8(IL-8)and interleukin-10(IL-10),tumour necrosis factor(TNF alpha),interleukin-1β(IL-1β).The incidence of uremia,major cardiovascular events,and survival were compared between the two groups after 12 months of follow-up.Results The levels of SCR and BUN in the observation group were lower than those in the control group(P<0.05);After treatment,the BNP level in the observation group was lower than that in the control group,and HR was significantly slower than that in the control group(P<0.05);Serum IL-8 and TNF in the observation group after treatment-α、IL-1βThe level of IL-10 in the control group was significantly higher than that in the control group(P<0.05);There was no death in hospital between the two groups.They were followed up.There was no significant difference in the incidence of uremia,the incidence of major cardiovascular events and survival rate(P>0.05).Conclusion Bedside renal replacement therapy can improve heart kidney syndrome in patients with renal function,remove inflammatory factors but not influence short-term prognosis,and deserve further research and application.

关 键 词：心肾综合征 床旁肾脏替代治疗 炎症反应 主要心血管事件 短期预后 

分 类 号：R541[医药卫生—心血管疾病]