连续性血液净化改善重症肺炎合并心力衰竭患者心功能的效果观察

Clinical efficacy of continuous blood purification in the treatment of severe pneumonia patients with heart failure

目的观察连续性血液净化(CBP)改善重症肺炎合并心力衰竭患者心功能的效果。方法选取重症肺炎合并心力衰竭的40例患者作为研究对象,随机分为实验组及对照组,对照组予以常规治疗,实验组在此基础上予以CBP治疗。观察并比较两组患者水肿消退时间,呼吸困难缓解时间,心率过快缓解时间,BNP,LVEF,CI,TNF-α,IL-6,IL-8,IL-10等指标。结果实验组水肿消退时间,呼吸困难缓解时间,心率过快缓解时间均明显短于对照组(P<0.05)。实验组患者经治疗后BNP显著低于对照组(P<0.05),LVEF,CI均明显大于对照组(P<0.05)。治疗后6 h、12 h、24 h、48 h、72 h,实验组患者血清TNF-α,IL-6,IL-8,IL-10浓度均明显低于对照组(P<0.05)。结论连续性血液净化可明显改善重症肺炎合并心力衰竭患者心功能,值得推广应用。

Objective To investigate the clinical efficacy of continuous blood purification in the treatment of severe pneumonia patients with heart failure. Methods 40 cases of severe pneumonia patients with heart failure were enrolled and randomly subdivided into test group（ n = 20） and control group（ n = 20）. Both groups got routine treatment. However,patients in test group received CBP for treatment. Regression time of edema,the improvement of dyspnoea and hyper-arryhthmia,BNP,LVEF,CI,TNF-α,IL- 6,IL- 8 and IL- 10 were observed and compared.Results Regression time of edema,dyspnoea and hyper- arryhthmia of test group were shorter than the control group（ P〈0. 05）. The BNP went down in a larger range in test group than that in control group and the improvements of LVEF and CI were significant higher in test group（ P〈0. 05）. In addition,after treatment for 6h,12 h,24h,48 h and 72 h,the decrease of TNF-α,IL-6,IL-8,IL-10 was more obvious in test group than those in control group（ P〈0. 05）. Conclusions Continuous blood purification can improve heart function of severe pneumonia patients with heart failure.