连续血液净化治疗尿毒症伴难治性心衰分析

Evaluation of therapeutic effect of continuous blood purification in uremia patients with refractory heart failure

目的探讨连续血液净化治疗尿毒症伴难治性心衰的效果。方法对165例尿毒症伴难治性心衰患者进行连续血液净化治疗,观察分析治疗前后心功能、心衰参数、心脏负荷指数、尿毒症毒素水平、血液酸碱平衡和血钾的变化。结果根据NYHA分级心功能改善情况,总有效率和显效率分别为90.3%和59.4%;治疗后心脏指数(CI)、左室射血分数(LVEF)、B型钠尿肽(BNP)等心衰参数有明显改善(P<0.05);中心静脉压(CVP)、平均动脉血压(MAP)等心脏负荷指数明显下降(P<0.05);尿毒症毒素水平显著下降(P<0.05),代谢性酸中毒、高钾血症得到基本纠正。结论连续血液净化对治疗尿毒症伴难治性心衰是一种具有良好效果的方法。

Objective To evaluate the therapeutic effect of continuous blood purification（CBP）in uremia patients with refractory heart failure. Methods 165 uremia patients with refractory heart failure were treated with CBP,changes of cardiac function, heart failure parameters, cardiac effort indexes, uremic toxin levels,blood acid-base balance and Blood potassium were investigated before and after CBP treatment.Results According to the improved NYHA class, the total effective rate and markedly effective rate were 90.3% and 59.4% .Heart failure parameters, such as cardiac index（CI）,left ventricle eject fraction（LVEF）,brain natriuretic peptide（BNP） were improved significanfly（P〈0.05）.Cardiac effort indexes such as central venous pressure（CVP）,mean artery pressure（MAP）were declined obviously（P〈0.O5）.Uremic toxin levels were declined apparently（P〈0.05）,metabolic acidosis and hyperkalemia were redressed basically.Conclusion CBP is an effective method with good Results on treating uremia patients with refractory heart failure.