酚妥拉明辅助连续血液净化治疗急性心力衰竭的应用研究  

Application of phentolamine assisted continuous blood purification in treatment for acute heart failure

作　　者：何炎佳 周婧 张磊[2] HE Yanjia;ZHOU Jing;ZHANG Lei(Department of Critical Care Medicine,the First People's Hospital of Nanyang,Nanyang,Henan 473000,China;Department of Cardiology,Henan Provincial People's Hospital,Zhengzhou,Henan 450000,China)

机构地区：[1]南阳市第一人民医院重症医学科,河南南阳473000 [2]河南省人民医院心内科,河南郑州450000

出　　处：《中国医学工程》2025年第4期92-96,共5页China Medical Engineering

摘　　要：目的观察酚妥拉明辅助连续血液净化治疗急性心力衰竭的临床效果。方法选取南阳市第一人民医院2021年1月至2023年6月收治的103例急性心力衰竭患者为研究对象,经电脑随机分组法将入组患者分别列为净化组(51例)和联合组(52例),净化组予以连续血液净化治疗,联合组采用酚妥拉明辅助血液净化治疗,比较两组患者的炎症反应、血管内皮功能、心肌损伤标志物、心功能及预后情况。结果在不同治疗方案下,联合组的五聚素3(PTX3)、生长分化因子-15(GDF-15)分别为(3.42±0.36)μg/L、(180.25±20.33)ng/L,均低于净化组[(4.22±1.37)μg/L、(195.25±20.31)ng/L](P<0.05);联合组的纤溶酶原激活抑制剂-1(PAI-1)、组织型纤溶酶原激活物(t-PA)、内皮素-1(ET-1)分别为(10.25±2.41)ng/mL、(3.42±0.35)ng/mL、(50.22±10.42)ng/L,均低于净化组[(12.36±3.23)ng/mL、(4.28±0.76)ng/mL、(55.42±10.36)ng/L](P<0.05);联合组的肌红蛋白(Myo)、肌酸激酶同工酶(CK-MB)、乳酸脱氢酶(LDH)分别为(60.29±10.33)μg/L、(10.49±2.35)U/L、(40.31±10.28)U/L,均低于净化组[(65.32±10.36)μg/L、(12.35±3.22)U/L、(45.44±10.31)U/L](P<0.05);联合组左心室射血分数(LVEF)为(55.39±10.23)%,高于净化组[(50.31±10.25)%](P<0.05),左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)分别为(115.34±20.36)mL、(55.43±10.26)mL,均低于净化组[(130.28±20.31)mL、(60.31±10.24)mL](P<0.05);联合组的不良预后发生率为3.85%(2/52),低于净化组[23.53%(12/51)](P<0.05)。结论酚妥拉明联合连续血液净化能减轻急性心力衰竭患者的炎症反应,对促进患者血管内皮功能恢复、减轻心肌损伤、改善心功能并降低不良预后发生风险均有积极意义。【Objective】To observe the clinical effect of phentolamine assisted continuous blood purification in the treatment for acute heart failure.【Methods】This prospective study selected 103 patients with acute heart failure admitted to the First People's Hospital of Nanyang from January 2021 to June 2023.The enrolled patients were randomly divided into a purification group(51 cases)and a combination group(52 cases)using computer randomization.The purification group received continuous blood purification treatment,while the combination group received phentolamine assisted blood purification treatment.The inflammatory response,endothelial function,myocardial injury markers,cardiac function,and prognosis of the two groups of patients were compared.【Results】Under different treatment regimens,the pentraxin 3(PTX3)and growth differentiation factor-15(GDF-15)of the combination group were 3.42±0.36μg/L,180.25±20.33 ng/L,lower than those of the purification group(4.22±1.37μg/L,195.25±20.31 ng/L)(P<0.05).The plasminogen activator inhibitor 1(PAI-1),tissue-type plasminogen activator(t-PA),and endothelin-1(ET-1)of the combination group were 10.25±2.41 ng/mL,3.42±0.35 ng/mL,and 50.22±10.42 ng/L,lower than those of the purification group(12.36±3.23 ng/mL,4.28±0.76 ng/mL,and 55.42±10.36 ng/L)(P<0.05).The myoglobin(Myo),creatine kinase-myocardial bank(CK-MB),and lactate dehydrogenase(LDH)of the joint group were 60.29±10.33μg/L,10.49±2.35 U/L,and 40.31±10.28 U/L,lower than those of the purification group(65.32±10.36μg/L,12.35±3.22 U/L,45.44±10.31 U/L)(P<0.05).The left ventricular ejection fraction(LVEF)of the combined group(55.39%±10.23%)was higher than the purification group(50.31%±10.25%),and the left ventricular end-diastolic volume(LVEDV)and left ventricular end-systolic volume(LVESV)were 115.34±20.36 mL and 55.43±10.26 mL,lower than the purification group(130.28±20.31 mL and 60.31±10.24 mL)(P<0.05).The incidence of poor prognosis in the combination group[3.85%(2/52)]was lower than the purificat

关 键 词：急性心力衰竭 酚妥拉明 连续血液净化 心肌损伤 预后情况 

分 类 号：R541.6[医药卫生—心血管疾病]