连续性肾脏替代治疗在1型心肾综合征中的应用价值

目的 探讨连续性肾脏替代治疗(CRRT)在1型心肾综合征中的应用价值。 方法 本研究回顾性分析温州市人民医院ICU 2008年6月~2014年8月就诊并给予CRRT治疗的1型心肾综合征患者,观察CRRT治疗前后平均动脉压、中心静脉压、休克指数、浅快呼吸指数、氧合指数、尿量、血浆氨基末端B型利钠肽前体、肌酐及碳酸氢根等临床数据的变化,以了解CRRT在1型心肾综合征中的的应用价值。 结果 37例1型心肾综合征患者入选,其中男性占51.4%,患者年龄27~88岁,平均年龄67.9±18.7岁。统计结果显示,CRRT治疗后,患者在平均动脉压、中心静脉压、休克指数、浅快呼吸指数、氧合指数、尿量、血浆氨基末端B型利钠肽前体、肌酐及碳酸氢根均明显好转,同治疗前比较差异有统计学意义(P<0.05)。 结论 CRRT对1型心肾综合征,尤其是伴严重利尿剂抵抗的重症CRS患者有极大的应用价值,甚至是唯一的治疗选择。

Value of Continuous Renal Replacement Therapy in the Treatment of the Type 1 Cardiorenal Syndrome

Objective To evaluate the value of Continuous renal replacement therapy(CRRT) in the treatment of the type 1 cardiorenal syndrome. Methods From June 2008 to August 2014,the type 1 cardiorenal syndrome patients receiving continuous renal replacement therapy in Wenzhou People's Hospital ICU were retrospectively analyzed. Before and after treatment, the mean arterial pressure, central venous pressure, shock index, rapid shallow breathing index, oxygenation index, urine, plasma amino-terminal pro-B-type natriuretic peptide precursor, creatinine and bicarbonate and other clinical data were observed in order to understand CRRT's value in type 1 cardiorenal syndrome patients. Results Total 37 patients [aged from 27-88(67.9±18.7)years,51.4%male] with type 1 cardiorenal syndrome were enrolled in this study. Statistics showed that after CRRT treatment, the mean arterial pressure, central venous pressure, shock index, rapid shallow breathing index, oxygenation index, urine, plasma amino-terminal pro-B-type natriuretic peptide precursor, creatinine and bicarbonate were significantly improved, and there was a significant difference(P<0.05). Conclusion For type 1 cardiorenal syndrome, especially critical patients with serious diuretic resistance, CRRT has great therapeutic value, even the only treatment option.