[1]钟家浩,黄志勇,黎凤美.不同血液净化方式对尿毒症并发心力衰竭病人疗效及心肌酶水平的影响[J].青岛大学学报(医学版),2018,54(04):407-409,414.[doi:10.11712/jms201804007]
 ZHONG Jiahao,HUANG Zhiyong,LI Fengmei.[J].JOURNAL OF QINGDAO UNIVERSITY (MEDICAL SCIENCES),2018,54(04):407-409,414.[doi:10.11712/jms201804007]
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不同血液净化方式对尿毒症并发心力衰竭病人疗效及心肌酶水平的影响()
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《青岛大学学报(医学版)》[ISSN:2096-5532/CN:37-1217/R]

卷:
第54卷
期数:
2018年04期
页码:
407-409,414
栏目:
出版日期:
2018-07-05

文章信息/Info

文章编号:
2096-5532(2018)04-0407-04
作者:
钟家浩黄志勇黎凤美
(惠州市第一人民医院肾病风湿科,广东 惠州 516000)
Author(s):
ZHONG Jiahao HUANG Zhiyong LI Fengmei
(Nephropathy Department of Rheumatism, The First People’s Hospital of Huizhou, Huizhou 516000, China)
关键词:
尿毒症心力衰竭肾透析治疗结果肌酸激酶L-乳酸脱氢酶羟丁酸脱氢酶
Keywords:
uremia heart failure renal dialysis treatment outcome creatine kinase L-lactate dehydrogenase hydroxybutyrate dehydrogenase
分类号:
R692.5;R459.5
DOI:
10.11712/jms201804007
文献标志码:
A
摘要:
目的 比较血液透析(HD)和血液透析联合灌流(HP+HD)两种不同的血液净化方式对尿毒症并发心力衰竭病人疗效及心肌酶水平的影响。
方法 选择2013年1月—2016年1月我院肾病风湿科收治的尿毒症并发心力衰竭病人120例,按照透析方法不同分为HD组(58例)和HP+HD组(62例)。对两组病人治疗前及治疗1、3个月后的肌酸磷酸激酶(CK)、乳酸脱氢酶(LDH)、羟丁酸脱氢酶(HBDH)水平,治疗后心功能改善情况及出院后1年生存率进行统计学分析。
结果 治疗后,HP+HD组的CK、LDH、HBDH水平均显著低于HD组(t=2.67~7.18,P<0.05);HP+HD组的心率、收缩压、舒张压、NYHA分级、超滤量、低血压发生率与HD组比较,差异均有统计学意义(t=17.66~149.61,χ2=7.39,P<0.01)。两组病人1年生存率比较,差异无统计学意义(P>0.05)。
结论 HP+HD较单纯的HD能更有效地降低尿毒症并发心力衰竭病人的心肌酶学指标,改善心功能及血流动力学水平,提高临床治疗效果。
Abstract:
Objective To investigate the effect of two different blood purification methods, hemodialysis (HD) and hemoperfusion (HP)+HD, on the outcome of patients with uremia complicated by heart failure and their effects on myocardial enzyme levels.
Methods A total of 120 patients with uremia complicated by heart failure who were admitted to Department of Nephrology in our hospital from January 2013 to January 2016 were enrolled and divided into HD group with 58 patients and HP+HD group with 62 patients according to the dialysis method. A statistical analysis was performed for the levels of creatine kinase (CK), lactate dehydrogenase (LDH), and hydroxybutyrate dehydrogenase (HBDH) before treatment and after 1 and 3 months of treatment, improvement in cardiac function after treatment, and 1-year survival rate.
Results After treatment, the HP+HD group had significantly lower levels of CK, LDH, and HBDH than the HD group (t=2.67-7.18, P<0.05). There were significant differences between the two groups in heart rate, systolic pressure, diastolic pressure, NYHA classification, ultrafiltration volume, and incidence rate of hypotension (t=17.66-149.61,χ2=7.39, P<0.01). There was no significant difference in 1-year survival rate between the two groups (P>0.05).
Conclusion Compared with HD, HP+HD can reduce myocardial enzyme levels and improve cardiac function, hemodynamic parameters, and clinical outcome more effectively in patients with uremia complicated by heart failure.
更新日期/Last Update: 2018-07-08