• 体外超滤治疗急性失代偿性心力衰竭的疗效与安全性
  • Efficacy and Safety for ultrafiltration therapy in acute decompensated heart failure
  • 智红,徐承义,邱如洁,刘成伟,吴明祥.体外超滤治疗急性失代偿性心力衰竭的疗效与安全性[J].内科急危重症杂志,2016,22(4):
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    中文关键词:  失代偿性心力衰竭  血液超滤装置 疗效  安全性
    英文关键词:Ultrafiltration  Acute decompensated  heart failure  Efficacy and  Safety
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    作者单位E-mail
    智红 武汉亚洲心脏病医院 baozhihong1982@126.com 
    徐承义 武汉亚洲心脏病医院  
    邱如洁 武汉亚洲心脏病医院  
    刘成伟 武汉亚洲心脏病医院  
    吴明祥 武汉亚洲心脏病医院 baozhihong1982@126.com 
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    中文摘要:
          目的:对血液超滤装置在心力衰竭患者应用安全性和有效性进行评价。方法:选择在我院CCU进行治疗的心力衰竭伴钠水潴留患者34例,其中扩张型心肌病伴心衰患者20例,缺血性心肌病伴心衰14例,采用血液超滤装置治疗,分析治疗前后呼吸困难评分、血氧饱和度、体重、血流动力学指标(心排量、心脏指数、胸液体容积、左心射血分数)、N-端脑钠肽前体(NT-proBNP)等指标,评价血液超滤的临床疗效,同时分析超滤前后的心率、血压、肝功能、肾功能、电解质、血常规等指标,进行安全性评价。结果:经治疗后,扩张型心肌病伴心衰患者及缺血性心肌病伴心衰患者的呼吸困难评分、血氧饱和度、体重、血流动力学指标(心排量、心脏指数、胸液体容积、左心射血分数)、NT-proBNP等指标均有改善,与治疗前相比有统计学意义(P<0.05)。治疗过程对患者血压、心率、血常规、肝功能、肾功能、电解质等无负面影响,且肾功能还有改善的趋势。结论:血液超滤装置治疗扩张型心肌病及缺血性心肌病伴心衰患者疗效明显,且安全可靠。
    英文摘要:
          Objective: TO investigated the efficacy and safety of ultrafiltration in acute decompensated heart failure patients. Methods: Thirty-four patients with heart failure and fluid overload in the CCU of our hospital were selected for the present ultrafiltration investigation. There are twenty dilated cardiomyopathy patients with heart failure, and fourteen ischemic cardiomyopathy patients with heart failure. The clinical efficiency was evaluated by comparing the primary end points with the corresponding values before ultrafiltration, and the primary end points included dyspnea scores, finger pulse oxygen saturation,body weight , hemodynamics (such as cardiac output, cardiac index, chest liquid volume, left ventricular ejection fraction), and NT proBNP levels. In addition, the safety of ultrafiltration was also investigated by evaluating the changes of heart rate, blood pressure, liver function, renal function, electrolyte and blood routine cause by ultrafiltration.SResults: Ultrafiltration benefits the dilated cardiomyopathy patients with heart failure, and also the ischemic cardiomyopathy patients with heart failure. The primary end points, including dyspnea scores, finger pulse oxygen saturation,body weight , hemodynamics (such as cardiac output, cardiac index, chest liquid volume, left ventricular ejection fraction), and NT proBNP levels were improved remarkably((P<0.05)). Ultrafiltration had no negative effect on heart rate, blood pressure, liver function, renal function, electrolyte and blood routine,and the renal function presented an improved trend. Conclusions: Ultrafiltration is an effective and safe therapeutic method, and it can benefit the dilated cardiomyopathy patients and the ischemic cardiomyopathy patients with heart failure.