连续性静脉-静脉血液滤过联合血液透析治疗糖尿病肾病伴心力衰竭的效果

Effect of Continuous Veno-Venous Hemofiltration Combined with Hemodialysis in the Treatment of Diabetic Nephropathy with Heart Failure

目的:观察在糖尿病肾病(DN)伴心力衰竭(HF)患者中应用连续性静脉-静脉血液滤过(CVVH)联合血液透析(HD)的效果.方法:选择原阳县人民医院2019年3月至2021年3月收治的DN伴HF患者74例,根据入院单的单双号分为观察组(双号,37例)与对照组(单号,37例),两组患者均接受常规治疗.在此基础上,观察组采用HD联合CVVH治疗,对照组仅采用HD治疗,两组均治疗3个月;于治疗前、治疗3个月后,比较两组肾功能[血肌酐(SCR)、血尿素氮(BUN)水平]、心功能[左室舒张末期内径(LVEDD)、左室射血分数(LVEF)].结果:治疗前,两组SCR、BUN水平及LVEDD、LVEF差异无统计学意义(P>0.05).治疗3个月后,两组SCR、BUN水平均下降,且观察组显著低于对照组(P<0.05);两组LVEDD均降低,LVEF均升高,且观察组变化显著(P<0.05).结论:CVVH联合HD用于DN伴HF患者中,可显著改善其肾功能及心功能.

Objective:To observe the effect of continuous veno-venous hemofiltration(CVVH)combined with hemodialysis(HD)in patients with diabetic nephropathy(DN)and heart failure(HF).Methods:Seventy-four patients with DM and HF treated in Yuanyang County People's Hospital from March 2019 to March 2021 were selected.According to the odd and even numbers of admission list,they were divided into observation group(37 cases with even numbers)and control group(37 cases with odd numbers).Both groups received routine treatment.On this basis,the observation group was treated with HD and CVVH,and the control group was treated with HD.Patients in both groups were treated for 3 months;before and after 3 months treatment,the renal function[levels of serum creatinine(SCR),blood urea nitrogen(BUN)],cardiac function[left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF)]were compared between the two groups.Results:Before treatment,the levels of SCR,BUN,LVEDD and LVEF in both groups were no statistically significant difference(P>0.05).After 3 months of treatment,the levels of SCR and BUN in both groups were decreased,and above indexes in the observation group was much lower than those of the control group(P<0.05).After 3 months of treatment,LVEDD was decreased and LVEF was increased in both groups,and changes in the observation group were significant than those in the control group(P<0.05).Conclusion:CVVH combined with HD can significantly improve renal and cardiac functions in patients with DN and HF.