连续性血液净化联合左西孟旦对重症肺炎合并心力衰竭患者临床疗效与炎症因子的影响  

Effect of continuous blood purification combined with levosimendan on clinical efficacy and inflammatory factors in patients with severe pneumonia complicated with heart failure

作　　者：张宾[1] 刘宁宁[2] 张伟[1] 瞿媛[1] 柏祥磊[1] ZHANG Bin;LIU Ning-ning;ZHANG Wei;QU Yuan;BAI Xiang-lei(Department of Emergency,Nanjing Hospital of Traditional Chinese Medicine,Nanjing 211000,Jiangsu,China;Department of Preventive Medicine,Health Management Center,Nanjing Hospital of Traditional Chinese Medicine,Nanjing 211000,Jiangsu,China)

机构地区：[1]南京市中医院急诊科,江苏南京211000 [2]南京市中医院治未病科·健康管理中心,江苏南京211000

出　　处：《川北医学院学报》2025年第3期340-343,共4页Journal of North Sichuan Medical College

基　　金：江苏省南京市中医药科技专项课题(ZYQN202207)。

摘　　要：目的:探讨连续性血液净化(CBP)联合左西孟旦对重症肺炎合并心力衰竭患者临床疗效与炎症因子的影响。方法:纳入86例重症肺炎合并心力衰竭患者作为研究对象,按照治疗方式不同分为对照组和观察组,每组各43例。对照组采用左西孟旦治疗;观察组在对照组治疗基础上予以CBP治疗。比较两组患者治疗效果、治疗前后超声心动图指标[左心射血分数(LVEF)、二尖瓣口血流速度(MV)、心排出量(CO)]、炎症指标[白细胞介素-6(IL-6)、降钙素原(PCT)]、酸碱平衡指标[pH值、碳酸氢根(HCO_(3^(-)))、动脉血氧分压(PaO_(2))]。结果:观察组治疗有效率高于对照组(P<0.05)。治疗后,两组LVEF、MV、CO均升高(P<0.05),且观察组LVEF、MV高于对照组(P<0.05),CO与对照组比较,差异无统计学意义(P>0.05);两组患者PCT、IL-6水平均下降,且观察组低于对照组(P<0.05);两组pH值、PaO_(2)均升高,且观察组高于对照组(P<0.05);HCO_(3)^(-)水平均下降,且观察组低于对照组(P<0.05)。结论:CBP联合左西孟旦可进一步改善重症肺炎合并心力衰竭患者心功能,减轻炎症反应,更好地调节酸碱平衡。Objective:To explore the effect of continuous blood purification(CBP) combined with levosimendan on the clinical efficacy and inflammatory factors in patients with severe pneumonia complicated with heart failure.Methods:86 patients with severe pneumonia and heart failure were selected and divided into two groups with 43 cases according to different treatment methods,the control group was treated with levosimendan,while the observation group received CBP treatment on top of the treatment provided to the control group.The therapeutic effects,echocardiographic indicators [left ventricular ejection fraction(LVEF),mitral valve flow velocity(MV),cardiac output(CO)],inflammation markers [interleukin-6(IL-6),procalcitonin(PCT)],and acid-base balance indicators [pH value,bicarbonate(HCO_(3)^(-)),arterial oxygen tension(PaO_(2))]before and after treatment were compared between the two groups.Results:The treatment efficacy rate was higher in the observation group than in the control group(P<0.05).After treatment,both groups showed increased LVEF,MV,and CO(P<0.05),with the observation group exhibiting greater increases in LVEF and MV compared to the control group(P<0.05),there was no significant difference in CO between the two groups(P>0.05).Post-treatment levels of PCT and IL-6 decreased in both groups,with a more significant decrease observed in the observation group(P<0.05).Additionally,both pH values,and PaO_(2) increased while HCO_(3)^(-)level decreased,and the change were more significant in the observation group(P<0.05).Conclusion:CBP combined with levosimendan can further improve cardiac function,reduce inflammatory responses,and better regulate acid-base balance in patients with severe pneumonia complicated by heart failure.

关 键 词：重症肺炎 心力衰竭 连续性血液净化 超声心动图 酸碱平衡 

分 类 号：R541.6[医药卫生—心血管疾病]