自动腹膜透析治疗对老年心肾综合征患者的疗效

Therapeutic efficacy of automatic peritoneal dialysis on elderly patients with cardiorenal syndrome

目的探讨自动腹膜透析治疗对老年心肾综合征(CRS)患者的疗效。方法回顾性分析2019年1月至2022年1月佛山市南海区人民医院治疗的老年CRS患者260例,根据随机数字表法,按照1?1将研究对象分为观察组和对照组,每组130例。对照组给予常规基础治疗和对症治疗,观察组在此基础上进行自动腹膜透析治疗。比较2组心功能指标、肾功能指标、炎性因子、平均动脉压(MAP)及心率。结果观察组治疗后左心室收缩末期内径、左心室舒张末期内径、左心房内径、N末端B型钠尿肽前体、尿素、胱抑素C、肌酐、肿瘤坏死因子α、高敏C反应蛋白水平低于对照组[(26.29±1.19)mm vs(29.59±1.84)mm,(47.43±1.39)mm vs(51.81±1.34)mm,(30.74±1.15)mm vs(33.11±0.88)mm,(1034.74±313.61)ng/L vs(2634.02±853.67)ng/L,(16.69±3.57)mmol/L vs(32.67±4.54)mmol/L,(0.47±0.13)mg/L vs(0.61±0.15)mg/L,(254.74±41.15)μmol/L vs(394.09±38.61)μmol/L,(144.14±23.16)mg/L vs(183.97±23.37)mg/L,(4.09±1.03)μg/L vs(5.45±1.17)μg/L,P<0.01],左心室射血分数水平高于对照组[(39.14±4.48)%vs(35.64±5.27)%,P<0.01]。2组治疗前、治疗后心率及MAP比较无显著差异(P>0.05)。结论自动腹膜透析治疗能够改善老年CRS患者的心功能、肾功能,降低炎性反应,对于改善预后具有积极意义。

Objective To explore the therapeutic efficacy of automatic peritoneal dialysis on elderly patients with cardiorenal syndrome(CRS).Methods A total of 260 elderly CRS patients treated at our hospital from January 2019 to January 2022 were recruited,and then randomly divided into an observation group and a control group,with 130 cases in each group.The control group received conventional basic treatment and symptomatic treatment,while the observation group received automated peritoneal dialysis treatment on this basis.Cardiac function indicators,renal function indicators,inflammatory factors,MAP and heart rate were compared between the two groups.Results After treatment,significantly lower LVESD(26.29±1.19 mm vs 29.59±1.84 mm),LVEDD(47.43±1.39 mm vs 51.81±1.34 mm),LAD(30.74±1.15 mm vs 33.11±0.88 mm),and levels of NT-proBNP(1034.74±313.61 ng/L vs 2634.02±853.67 ng/L),urea(16.69±3.57 mmol/L vs 32.67±4.54 mmol/L),cystatin C(0.47±0.13 mg/L vs 0.61±0.15 mg/L),creatinine(254.74±41.15 mmol/L vs 394.09±38.61 mmol/L),TNF-α(144.14±23.16 mg/L vs 183.97±23.37 mg/L)and hs-CRP(4.09±1.03μg/L vs 5.45±1.17μg/L),and higher LVEF(39.14±4.48%vs 35.64±5.27%)were observed in the observation group than the control group(all P<0.01).There were no significant differences in heart rate and MAP between the two groups before and after treatment(P>0.05).Conclusion Automatic peritoneal dialysis can improve the cardiac and renal function and reduce inflammatory response in elderly CRS patients,and show positive significance for improving prognosis.