中国血液净化

中国血液净化 ›› 2021, Vol. 20 ›› Issue (02): 86-89.doi: 10.3969/j.issn.1671-4091.2021.02.004

• 临床研究 • 上一篇    下一篇

老年难治性心力衰竭患者连续性肾脏替代治疗的效果及对血清因子水平的影响

王蔚蔚1,程艳2,刘博雷1,肖普1,王顺1   

  1. 郑州市第三人民医院1心血管内科2肾内二病区
  • 收稿日期:2020-07-09 修回日期:2020-11-06 出版日期:2021-02-12 发布日期:2021-02-23
  • 通讯作者: 王蔚蔚 w_ww8007@163.com E-mail:w_ww8007@163.com

Effect of continuous renal replacement therapy on elderly patients with refractory heart failure and its effect on serum factor levels 

  1. 1Department of Cardiovascular Disease, 2Department of Nephrology, The Third People's Hospital of Zhengzhou, Zhengzhou 450000, China
  • Received:2020-07-09 Revised:2020-11-06 Online:2021-02-12 Published:2021-02-23

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摘要： 【摘要】目的探讨老年难治性心力衰竭患者连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)的效果及对血清C 反应蛋白(Creactive protein，CRP)、半乳糖凝集素-3(galectin-3，Gal-3)、氨基末端脑钠肽前体(N-terminal pro-brain natriuretic peptide, NT-proBNP)、人心型脂肪酸结合蛋白(heart fatty acid binding protein，H-FABP)、微管连接蛋白(Nexilin)水平的影响。方
法选取郑州市第三人民医院2016 年6 月～2018 年2 月收治的84 例难治性心力衰竭老年患者，采用随机数字表法分为研究组和对照组各42 例，2 组均予以常规治疗，研究组同时给予CRRT 治疗；对比2 组患者治疗前后的左心室射血分数(left ventricular ejection fraction,LVEF)、每搏输出量(stroke volume,SV)、左心室舒张末期内径(left ventricular end diastolic diameter,LVEDD)、二尖瓣血流最大流速E 峰/A 峰(maximum flow velocity of mitral valve E peak/A peak,E/A)、血清CPP、Gal-3、NT-proBNP、H-FABP 及Nexilin、临床效果。结果治疗后，研究组的LVEF、SV、E/A 测定值高于对照组(t 值分别为3.081, 4.131. 3.043；P 值分别为0.003, ＜0.001，0.003)，研究组的LVEDD 测定值低于对照组(t=-3.520，P=0.001)；研究组的血清CPP、Gal-3、NT-proBNP、H-FABP 及Nexilin 测定值低于对照组(t 值分别为-7.468,-6.315,-5.008,-4.133,-5.361;P 值分别为＜0.001，＜0.001，＜0.001，＜0.001，＜0.001)；研究
组和对照组的临床疗效对比，研究组优于对照组(Z=-2.012、P=0.044)。结论CRRT 治疗难治性心力衰竭较常规治疗方法具有更好的效果，能有效的降低血清CPP、Gal-3、NT-proBNP、H-FABP 及Nexilin水平。

关键词: 连续性肾脏替代治疗, 难治性心力衰竭, C 反应蛋白, 半乳糖凝集素-3, 氨基末端脑钠肽前体, 人心型脂肪酸结合蛋白, Nexilin

Abstract: 【Abstract】Objective To investigate the effect of continuous renal replacement therapy (CRRT) in the treatment of elderly patients with refractory heart failure and its effect on serum levels of C reactive protein (CRP), galectin-3 (Gal-3), N-terminal pro-brain natriuretic peptide (NT-proBNP), heart fatty acid binding protein (H-FABP) and Nexilin. Methods We recruited 84 elderly patients with refractory heart failure admitted to our hospital from June 2016 to February 2018, and randomly divided them into study group (n=42) and control group (n=42). While all patients received the conventional treatment, patients in study group were also treated with CRRT. Left ventricular ejection fraction(LVEF), stroke volume(SV), left ventricular end-diastolic diameter (LVEDD), maximum mitral flow velocity E-peak/A-peak (E/A), serum levels of CRP, Gal-3, NTproBNP, H-FABP and Nexilin, and clinical effects were compared before and after CRRT between the two groups. Results After the treatment, LVEF, SV and E/A became higher in study group than in control group (t=3.081, 4.131 and 3.043 respectively; P=0.003, 0.000 and 0.003 respectively); LVEDD and the serum levels of CPP, Gal-3, NT-proBNP, H-FABP and Nexilin were lower in study group than in control group (t=-3.520, -7.468, -6.315, -5.008, -4.133 and -5.361 respectively; P=0.001, 0.001,＜0.001,＜0.001,＜0.001 and＜0.001 respectively). Clinical effects were also better in study group than in control group(Z=-2.012, P=0.044). Conclusion CRRT is better than the conventional therapy in the treatment of elderly patients with refractory heart failure. CRRT can also significantly reduce the serum levels of CRP, Gal-3, NT-proBNP, H-FABP and Nexilin.

Key words: Continuous renal replacement therapy, Refractory heart failure, C-reactive protein, Galectin-3, N-terminal pro-brain natriuretic peptide, Heart fatty acid binding protein, Nexilin

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