超滤治疗老年心力衰竭合并衰弱患者的有效性及安全性  

Efficacy and safety of ultrafiltration in the treatment for elderly patients with heart failure and frailty

作　　者：徐斌 诸赟 陈浩[1] 朱红俊[1] 高枫[1] 夏丛奕 钟玲 苏伟[1] XU Bin;ZHU Yun;CHEN Hao;ZHU Hongjun;GAO Feng;XIA Congyi;ZHONG Ling;SU Wei(Department of Cardiovascular Medicine,Wuxi Traditional Chinese Medicine Hospital,Wuxi 214071,China)

机构地区：[1]无锡市中医医院心血管内科,214071

出　　处：《天津医药》2024年第7期743-747,共5页Tianjin Medical Journal

基　　金：无锡市中医药管理局科技项目重点项目(ZYZD01);无锡市科技发展指导性计划(医疗卫生)项目(CSZON1618);无锡市“太湖人才计划”医疗卫生高层次人才项目(2020年度)。

摘　　要：目的探讨超滤治疗老年心力衰竭(心衰)合并衰弱患者的有效性及安全性。方法88例老年心衰合并衰弱的住院患者随机分为常规组和超滤组,各44例。常规组给予药物治疗,超滤组在药物治疗的基础上进行超滤治疗,但在超滤治疗期间不使用利尿剂。比较2组疗效评价指标:治疗48 h后患者体质量、N末端B型利钠肽原(NTproBNP),治疗48 h及1周后呼吸困难难度评分、住院时间、3个月内再次住院率。安全性评价指标:治疗48 h后患者血肌酐、血尿素氮、血钠、血钾,治疗1周后患者血肌酐。结果疗效评价指标:2组患者治疗48 h后体质量、NTproBNP均较治疗前降低(P<0.05),治疗前后2组体质量、NT-proBNP差异均无统计学意义(P>0.05);2组治疗48 h后患者呼吸困难难度评分均较治疗前升高,治疗1周后降低,超滤组治疗48 h后呼吸困难难度评分高于常规组(P<0.05);超滤组住院时间和3个月内再住院率均低于常规组(P<0.05)。安全性评价指标:治疗前及治疗48 h后2组血尿素氮、血钠差异均无统计学意义(P>0.05),超滤组治疗48 h后血钾高于常规组(P<0.05);常规组治疗前后血肌酐无明显变化(P>0.05);超滤组治疗1周后血肌酐低于治疗前及治疗48 h,且低于常规组(P<0.05)。结论超滤治疗老年心衰合并衰弱是一种安全有效的治疗方法。Objective To investigate the efficacy and safety of ultrafiltration therapy in elderly patients with congestive heart failure(CHF)and frailty.Methods A total of 88 hospitalized elderly patients with CHF and frailty were randomly assigned to the ultrafiltration group(n=44)and the control group(n=44).The control group treated with standard drug therapy.The ultrafiltration group treated with ultrafiltration,however,diuretics were not used during ultrafiltration treatment.Efficacy assessment was compared between the two groups,including patient body weight,N-terminal pro-brain natriuretic peptide(NT-proBNP)levels at 48 hours after treatment,dyspnea severity scores at 48 hours and 1 week after treatment,hospitalization duration and readmission rate within 3 months.Safety assessment parameters included serum creatinine,urea nitrogen,Na+and K+concentration at 48 hours after treatment and creatinine level 1 week after treatment.Results Efficacy assessment indicated that at 48 hours after treatment,both groups showed a significant reduction in patient body weight and NT-proBNP levels compared to pre-treatment levels(P<0.05).However,there were no significant difference in body weight and NT-proBNP levels before and after treatment between the two groups(P>0.05).Dyspnea severity scores for both groups increased at 48 hours after treatment,then decreased at 1 week after treatment.The ultrafiltration group exhibited higher dyspnea severity scores than that of the control group at 48 hours after treatment(P<0.05).The length of hospital stay and the rate of re-hospitalization within 3 months were lower in the ultrafiltration group compared to those of the control group(P<0.05).Safety assessment revealed that there were no significant differences in serum urea nitrogen and Na+levels before and 48 hours after treatment between the two groups(P>0.05).However,serum K+levels were higher after 48-hours treatment in the ultrafiltration group than those of the control group(P<0.05).There were no significant changes in creatinine levels

关 键 词：心力衰竭 衰弱 老年人 超滤 

分 类 号：R541.4[医药卫生—心血管疾病]