慢性心力衰竭伴顽固性水肿血液超滤治疗策略及效果观察

Blood ultrafiltration for patients with chronic heart failure and stubborn edema

目的观察血液超滤治疗慢性心力衰竭伴顽固性水肿的临床疗效。方法 2008年3月至2010年12月期间,纳入21例在成都医学院第一附属医院肾内科住院的慢性心力衰竭伴顽固性水肿患者,采用病例序列研究方法观察血液超滤治疗的临床疗效。评价指标为超滤前后体重、B型尿钠肽(brain natriuretic peptide,BNP)和左心射血分数(left ventricular ejection fraction,LVEF)的变化情况。结果超滤后体重较治疗前减轻4.5～11.3 kg,LVEF值(45.6±9.4)%较超滤前(38.5±7.6)%增加(P<0.05),而BNP浓度(175.4±64.1)pg/ml则较前(603.2±88.5)pg/ml大幅下降(P<0.01)。结论血液超滤技术可改善慢性心力衰竭伴顽固水肿患者的心功能、水肿状态和尿量。

Objective To observe the clinical curative effect of blood ultrafiltration therapy for chronic heart failure with refractory edema.Methods From March 2008 to December 2010,21 cases of chronic heart failure with refractory edema in our hospital were studied.Case study method was used to observe the clinical curative effect of blood ultrafiltration technology.Weight,blood reactive,electrolyte,kidney change of brain natriuretic peptide,BNP and left ventricular ejection fraction（LVEF）before and after ultrafiltration were evaluated.Results Body weight reduced 4.5～11.3 kg after ultrafiltration,while LVEF value increased after ultrafiltration [（38.5±7.6）vs（45.6±9.4）,P0.05）].The concentration of BNP significantly decreased after ultrafiltration [（175.4±64.1）vs（603.2±88.5）,P0.01].Conclusion Blood ultrafiltration technology improves the cardiac function,edema and urine output for chronic heart failure patients with refractory edema,so that patients can smoothly come into etiological treatment stage.