根据血尿素氮/肌酐比值探讨低血容量心力衰竭的容量管理策略

Exploring blood volume management strategy for heart failure with hypovolumia according to blood urea nitrogen/blood creatinine

目的:根据血尿素氮(blood urea nitrogen)/肌酐(creatinine)比值(BUN/Cr)探讨低血容量心力衰竭患者的容量管理策略。方法:将我院80例BUN/Cr≥20:1的心力衰竭患者随机分为对照组(40例)和实验组(40例),对照组根据心力衰竭指南给予标准治疗,实验组在标准治疗基础上停用利尿剂,给予液体治疗,待容量恢复(BUN/Cr<20:1)后再启动利尿剂治疗。2周后,对两组患者的临床疗效、血压、心率、肾功能、脑钠肽及左室射血分数进行比较。结果:实验组总有效率(95.00%)显著高于对照组(57.50%),差异有统计学意义(P<0.005)。实验组血压、心率、肾功能、脑钠肽及左室射血分数均明显改善,与对照组相比有显著差异(P<0.05)。结论:根据心力衰竭患者的BUN/Cr能够判断患者的容量状况,据此制定的容量管理策略安全有效。

Objective:To explore blood volume management strategy for heart failure patients with hypovolumia according to blood urea nitrogen/blood creatinine(BUN/Cr).Methods:80 heart failure patients with BUN/Cr≥20:1 were divided into control group(40 cases)and test group(40 cases)by random.The control group was given standard treatment according to the guidelines for heart failure.The test group was given liquid treatment without diuretics on basis of standard treatment,and then restarted diuretic therapy after blood volumn recovery(BUN/Cr<20:1).2 weeks later,the clinical efficacy of two groups was compared.And blood pressure,heart rate,renal function,brain natriuretic peptide and left ventricular ejection fraction of two groups were compared.Results:The total effective rate(95.00%)of the test group was significantly higher than that of the control group(57.50%),and the difference was statistically significant(P<0.005).The blood pressure,heart rate,renal function,brain natriuretic peptide and left ventricular ejection fraction of the test group were significantly improved,there were significant differences compared with control group(P<0.05).Conclusion:The blood volume of heart failure patients can be assessed according to BUN/Cr correctly.Accordingly the blood volume management strategy is safe and effective.