CAJ | 학술논문

目的探讨床旁连续性血液净化（CBP）治疗对难治性心力衰竭（RHF）患者左心室功能和心律失常的影响。方法37例难治性心力衰竭患者在标准药物治疗基础上联合床旁连续性血液净化治疗，观察治疗前后左心功能指标及心律失常改善情况。结果37例患者采用CBP治疗后，32例有效，其中心功能改善2级以上14例（37.8%），心功能改善1级以上18例（48.6%），总有效率为86.5%。治疗后左心室舒张末期内径（LVD）较治疗前减小、左心室射血分数（LVEF）增加，B型脑钠肽（BNP）下降；随着血清钾、钠、氯恢复正常，心室负荷减轻，心律失常有所改善，与治疗前比较，差异有统计学意义（P<0.05）。结论连续性血液净化能有效改善难治性心力衰竭左心室功能，降低BNP，改善心律失常，短期效果佳。
목적탐토상방련속성혈액정화（CBP）치료대난치성심력쇠갈（RHF）환자좌심실공능화심률실상적영향。방법37례난치성심력쇠갈환자재표준약물치료기출상연합상방련속성혈액정화치료，관찰치료전후좌심공능지표급심률실상개선정황。결과37례환자채용CBP치료후，32례유효，기중심공능개선2급이상14례（37.8%），심공능개선1급이상18례（48.6%），총유효솔위86.5%。치료후좌심실서장말기내경（LVD）교치료전감소、좌심실사혈분수（LVEF）증가，B형뇌납태（BNP）하강；수착혈청갑、납、록회복정상，심실부하감경，심률실상유소개선，여치료전비교，차이유통계학의의（P<0.05）。결론련속성혈액정화능유효개선난치성심력쇠갈좌심실공능，강저BNP，개선심률실상，단기효과가。
Objective To investigate the influence of the bedside continuous blood purification(CBP) treatment for left ventricular function and arrhythmia in patients with refractory heart failure (RHF). Methods Based on the standard drug treatment, 37 cases with refractory heart failure were used bedside continuous blood purification treatment, and the left ventricular function index and improvement of arrhythmia were observed before and after treatment. Results In 37 cases with the CBP treatment, 32 cases were effective, cardiac function improved for two grades in 14 cases(37.8%), improved for two grades in 18 cases(48.6%), the total effective rate was 86.5%. The left ventricular end-diastolic volume (LVD) was reduced, the ejection fraction (LVEF) was increased, serum brain natriuretic peptide(BNP) was decreased(P<0.05). With the serum potassium, sodium, chloride return to norma, the ventricular load was reduced, the arrhythmia was improvement, it was statistically significant (P<0.05). Conclusion Continuous blood purification(CBP) can improve the left ventricular function of refractory heart failure, reduce the BNP (brain natriuretic peptide), improve arrhythmia, the short-term effect is good.