临床方案；_心力衰竭_充血性；

CRRT治疗老年顽固性心力衰竭的疗效观察

http://www.100md.com 《实用老年医学》 2006年第4期

临床方案；,心力衰竭,充血性；,老年人,1对象与方法,2结果,3讨论,参考文献

     【摘要】目的研究连续性肾脏替代疗法(CRRT)治疗老年顽固性心力衰竭(CHF)的疗效，观察其血流动力学、生化及神经内分泌等方面的变化，探讨其临床意义。方法观察59例顽固性CHF病人治疗前后血清K+、Na+、Cl-、尿素氮(BUN)、肌酐(Cr)、白蛋白(ALB)等生化指标，去甲肾上腺素(NE)、肾上腺素(E)、血浆肾素活性(PRA)、血管紧张素Ⅱ(AngⅡ)、醛固酮(ALD)等神经内分泌激素及心脏指数(CI)、心率(HR)平均肺动脉压(MPAP)、肺动脉楔压(PAWP)、平均周围动脉血压(MBP)、平均右房压(MRAP)、肺血管阻力(PVR)等血流动力学的变化。结果治疗后血液生化指标(K+、Na+、ALB)、血流动力学指标(HR、CI、MPAP、PAWP)及神经内分泌指标(NE、ALD、PRA、AngⅡ)均有明显改善。结论采用CRRT治疗顽固性CHF，能改善血流动力学，在一定程度上对神经内分泌激素方面进行干预，不失为顽固性CHF治疗的有效措施。

    【主题词】临床方案；心力衰竭，充血性；老年人

    Clinical efficacy of continuous renal replacement therapy in elderly patients with complicated chronic heart failure

    FANG Weihua, CHEN Youdong, YAN Xing.

    Department of Cardiology, The 82nd Hospital of PLA, Huaian 223001 China；SU Hang.Department of Nephrology，Affiliated Hospital of the Academy of Military Medical Science，Beijing 100039 China

    【Abstract】 Objective To investigate the clinical efficacy of continuous renal replacement therapy(CRRT) for complicated chronic heart failure(CHF) in elderly patients. Methods Fiftynine elderly patients with CHF (mean age 667±54 years old) were measured of biochemical parameters, plasma concentrations of neuroendocrine and hemodynamics before and after treatment. The data were used for statistical analysis. Resukts After treatment, the biochemical parameters, plasma concentrations of neuroendocrine and hemodynamics were improved significantly(P<001) . Conckusions The results suggest that CRRT is an effective method to treat complicated CHF. ......

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