疑难病杂志
疑難病雜誌
의난병잡지
Chinese Journal of Difficult and Complicated Cases
2015年
10期
1039-1042
,共4页
连续性肾脏替代治疗%心肾综合征%疗效
連續性腎髒替代治療%心腎綜閤徵%療效
련속성신장체대치료%심신종합정%료효
Continuous renal replacement therapy%Cardiac and renal syndrome%Efficacy
目的：观察连续性肾脏替代治疗对老年心肾综合征（ CRS）患者的临床疗效。方法选择老年CRS （I型）患者117例，按随机数字表法分为观察组（58例）与对照组（59例），对照组患者给予常规内科药物治疗，观察组在对照组治疗基础上加用连续性肾脏替代治疗。分别于治疗前及治疗后24 h检测并比较心肾功能及炎性因子等指标。结果治疗前，2组患者平均动脉压（ MAP）、心率（ HR）、APACHE II评分比较差异无统计学意义（ P ＞0?．05）；治疗24 h后，2组患者尿中性粒细胞明胶酶相关脂质转运载蛋白（ NGAL）以及血清CK-MB、cTnT、BNP、SCr、胱抑素-C （Cys-C）、TNF-α、CRP、IL-6水平较治疗前降低，且观察组优于对照组（ P ＜0．05）。观察组24 h MAP、72 h日均尿量（ ml／d）较对照组明显上升，HR、APACHE II评分、7日内气管插管率及临床病死率较对照组下降，2组比较差异均有统计学意义（ P ＜0．05）。结论连续性肾脏替代治疗能有效缓解心脏负荷，减少肾脏损伤，稳定生命体征，减少临床病死率。
目的：觀察連續性腎髒替代治療對老年心腎綜閤徵（ CRS）患者的臨床療效。方法選擇老年CRS （I型）患者117例，按隨機數字錶法分為觀察組（58例）與對照組（59例），對照組患者給予常規內科藥物治療，觀察組在對照組治療基礎上加用連續性腎髒替代治療。分彆于治療前及治療後24 h檢測併比較心腎功能及炎性因子等指標。結果治療前，2組患者平均動脈壓（ MAP）、心率（ HR）、APACHE II評分比較差異無統計學意義（ P ＞0?．05）；治療24 h後，2組患者尿中性粒細胞明膠酶相關脂質轉運載蛋白（ NGAL）以及血清CK-MB、cTnT、BNP、SCr、胱抑素-C （Cys-C）、TNF-α、CRP、IL-6水平較治療前降低，且觀察組優于對照組（ P ＜0．05）。觀察組24 h MAP、72 h日均尿量（ ml／d）較對照組明顯上升，HR、APACHE II評分、7日內氣管插管率及臨床病死率較對照組下降，2組比較差異均有統計學意義（ P ＜0．05）。結論連續性腎髒替代治療能有效緩解心髒負荷，減少腎髒損傷，穩定生命體徵，減少臨床病死率。
목적：관찰련속성신장체대치료대노년심신종합정（ CRS）환자적림상료효。방법선택노년CRS （I형）환자117례，안수궤수자표법분위관찰조（58례）여대조조（59례），대조조환자급여상규내과약물치료，관찰조재대조조치료기출상가용련속성신장체대치료。분별우치료전급치료후24 h검측병비교심신공능급염성인자등지표。결과치료전，2조환자평균동맥압（ MAP）、심솔（ HR）、APACHE II평분비교차이무통계학의의（ P ＞0?．05）；치료24 h후，2조환자뇨중성립세포명효매상관지질전운재단백（ NGAL）이급혈청CK-MB、cTnT、BNP、SCr、광억소-C （Cys-C）、TNF-α、CRP、IL-6수평교치료전강저，차관찰조우우대조조（ P ＜0．05）。관찰조24 h MAP、72 h일균뇨량（ ml／d）교대조조명현상승，HR、APACHE II평분、7일내기관삽관솔급림상병사솔교대조조하강，2조비교차이균유통계학의의（ P ＜0．05）。결론련속성신장체대치료능유효완해심장부하，감소신장손상，은정생명체정，감소림상병사솔。
Objective To observe the clinical effect of continuous renal replacement therapy in elderly patients with cardiac and renal syndrome (CRS).Methods One hundred and seventeen cases of elderly patients with CRS (type I) were randomly divided into observation group (58 cases) and control group (59 cases).The control group was treated with routine medicine treatment .The observation group was treated with continuous renal replacement therapy on the basis of control group.24 h before and after treatment , heart and kidney function , inflammatory factor were detected and compared between the two groups .Results Before treatment , the two groups of patients ’ mean arterial pressure ( MAP ) , heart rate ( HR ) , APACHE II score’s difference showed no statistical significance ( P >0.05);24 h after treatment, 2 groups of patients’ uri-nary neutrophil gelatinase-associated lipid transfer protein (NGAL), serum CK-MB, cTnT, BNP, serum creatinine, cystatin C (Cys-C), TNF alpha, CRP, IL-6 levels were decreased compared with those before treatment , and the observation group was better than the control group ( P <0.05).Observation group’s 24 h MAP, 72 h average daily urine volume (ml/d) were increased obviously compared with the control group , HR, APACHE II score, 7 day’s endotracheal intubation rate and clinical fatality rate decreased compared with the control group , 2 group ’ s differences were statistically significant ( P <0.05).Conclusion Continuous renal replacement therapy can effectively relieve cardiac load , reduce kidney damage , stable vital signs, reduce the clinical mortality.
