摘要
目的 :比较连续性静脉—静脉血液滤过或连续性动脉—静脉血液滤过 (CVVH/CAVH)与间歇性血液透析 (IHD)治疗慢性肾功能衰竭 (CRF)并发充血性心力衰竭 (CHF)患者的血液动力学特点、溶质清除方面的差异 ,并评价它们的治疗效果 ,以探讨CVVH/CAVH对心脏的保护作用。方法 :12 8例次CRF并发CHF的病人 ,72例次接受CVVH/CAVH治疗 ,5 6次例接受IHD治疗。所有患者记录治疗前后超滤液量 ;观察治疗前和治疗中、治疗后患者的心率、血压、肺部体征的变化以及患者的不适反应 ;测定治疗前、后的肾功能、电解质、血 β2 -微球蛋白 (β2 -MG) ,血甲状旁腺值 (PTH)。结果 :(1)CVVH/CAVH组超滤液量明显高于IHD组 (P <0 .0 5 ) ;(2 )IHD组低血压的发生率和不适反应评分均高于CVVH/CAVH组 (P <0 .0 5 ) ;(3)CVVH/CAVH组心功能的改善情况明显好于IHD组 (P <0 .0 5 ) ;④CVVH/CAVH组不仅能清除BUN、Scr,还能清除PTH和β2 -MG ,治疗前后的差异有显著的意义 (P <0 .0 5 )。结论 :CVVH/CAVH具有稳定的血流动力学 ,对心血管系统的干扰小 ,病人的耐受性好 ,并且还能清除PTH、β2 -MG等 ,有助于保护和恢复心功能。
Objective:To explore the protective effects of CVVH/CAVH on heart by comparing the behavior of blood kinetics,the difference in solute clearance,and the therapeutic efficacy between CVVH/CAVH and IHD on patients of chronic renal failure(CRF) with congestive heart failure(CHF).Methods:Employed 128 CRF cases with CHF,72 recieved CVVH/CAVH and 56 underwent IHD.In all patients,volumes of ultrafiltrate were recorded.The patients′ heart rates,blood pressure,and signs of lungs were observed,and the markers of biochemistry were detected.Results:(1)The volumes of ultrafiltrati in CVVH/CAVH were higer in IHD (P<0.05).(2)The incidence of hypotension and the score of upset response in IHD were higher in CRRT(P<0.05).(3)The heart function in CVVH/CAVH were improved tetter than in IHD.(4)CVVH/CAVH could not only remove BUN and Scr but also remove PTH and β 2-MG.Conclusion:CVVH/CAVH plays an important role in improving heart function beyond IHD.
出处
《重庆医科大学学报》
CAS
CSCD
2004年第1期27-30,共4页
Journal of Chongqing Medical University
