磷酸肌酸钠治疗Ⅳ型心肾综合征的临床观察

Observation of Creatine Phosphate Sodium in the Treatment of Type Ⅳ Cardiorenal Syndrome

目的观察在常规治疗中加用磷酸肌酸钠,对Ⅳ型心肾综合征心脏功能和炎性因子的影响。方法将72例心肾综合征患者随机分为观察组(38例)和对照组(34例)。对照组采用常规药物治疗,观察组再加用磷酸肌酸钠2.0 g静脉滴注,每日1次,连续用药14 d。比较两组治疗前后血肌钙蛋白T(c Tn T)、肌酸激酶同工酶(CK-MB)、血清钠尿肽(BNP)、左心室射血分数(LVEF)及超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)水平变化。结果治疗后两组c Tn T、CK-MB、BNP均较治疗前下降,LVEF较治疗前升高,差异具有统计学意义(P<0.05),且观察组疗效优于对照组(P<0.05)。治疗后hs-CRP、IL-6、TNF-α水平均较治疗前下降,且观察组较对照组下降更显著(P<0.05)。结论磷酸肌酸钠抑制炎性因子的过度激活可能是保护Ⅳ型心肾综合征患者脏器功能的机制之一。

Objective To investigate the effect of creatine phosphate sodium on cardiac function and inflammatory cytokines in patients with type Ⅳ cardiorenal syndrome on the basis of conventional therapy.Methods 72 cases of type Ⅳ cardiorenal syndrome were randomly divided into observation group（ 38 cases）and control group（ 32 cases）. Control group was used conventional drug therapy,while the observation group was used conventional therapy and creatine phosphate sodium 2. 0g,once daily and continuous application of14 d. The serum troponin T（ c Tn T）,creatine kinase isoenzyme（ CK-MB）,serum B type brain natriretic peptide（ BNP）,left ventricular ejection fraction（ LVEF）,the level of high-sensitivity C-reactive protein（ hsCRP）,interleukin-6（ IL-6） and tumor necrosis factor-α（ TNF-α） were observed between the two groups before and after treatment. Results After treatment the level of c Tn T,CK-MB and BNP in observation group were significantly reduced than the control group after treatment（ P〈0. 05）,while the level of LVEF was higher than the control group（ P〈0. 05）. The level of hs-CRP,IL-6 and TNF-α were significantly reduced after treatment（ P〈0. 05）,especially in the observation group（ P〈0. 05）. Conclusion The inflammatory factors activation inhibited by creatine phosphate sodium may be one of the protection mechanisms of type Ⅳ cardiorenal syndrome.