缓慢连续超滤对抗利尿性心肾综合征的疗效评价

Evaluation of Curative Effects on Slow Continuous Ultrafiltration Against Antidiuretic Cardiorenal Syndrome

目的探讨应用缓慢连续超滤(SCUF)在抗利尿性心肾综合征(CRS)患者中的临床疗效及运用价值。方法选取抗利尿性CRS患者64例进行SCUF治疗,比较治疗前、治疗后5 d、10 d患者日尿量、呼吸困难评分、血肌酐(s Cr)、N末端B型脑钠肽前体(NT-pro BNP)、白蛋白(ALB)、左心室射血分数(LVEF)和左室内径(LVD)的变化。结果治疗5 d后,实验组患者呼吸困难评分、NT-pro BNP、LVEF较治疗前及对照组均有不同程度改善,差异有统计学意义(P<0.05);治疗10 d后,实验组患者日尿量、呼吸困难评分、s Cr、NT-pro BNP、ALB、LVEF、LVD较治疗前均明显改善,差异有统计学意义(P<0.05)。结论合理应用SCUF对抗利尿性CRS的短期疗效明显,能有效改善心肾功能,减轻利尿剂抵抗。

Objective To research the clinical curative effects and value on slow continuous ultrafiltration(SCUF) in antidiuretic cardiorenal syndrome(CRS). Methods 64 CRS patients were selected to receive SCUF treatment, and we compared the patients’ changes of daily urine volume, dyspnea scores, serum creatinine(s Cr), B&N terminal pro brain natriuretic peptide(NT-proBNP),Albumin(ALB), left ventricular ejection fraction(LVEF) and Left ventricular diameter(LVD) before treatment,5 and 10 days after treatment. Re s ults5 days after treatment, there were more improvement on dyspnea scores,NT-proBNP and LVEF in the experience group than those before treatment and than the control group, and the results had statistical differences(P <0.05). 10 days after treatment, there were more obvious improvement on daily urine volume, dyspnea scores,s Cr, NT-proBNP, ALB, LVEF, and LVD in the experience group than those before treatment and than the control group,which had statistical differences(P < 0.05). Conclus ions Using SCUF reasonably against CRS could have obvious short-term efficacy and can effectively improve the cardiac and renal functions while reducing diuretic resistance.