持续性血液净化治疗顽固性心力衰竭73例疗效观察

目的：探讨持续性血液净化（CBP）治疗顽固性心力衰竭（心衰）的效果.方法：顽固性心衰患者114例,73例接受常规心衰药物及CBP治疗（CBP组）,41例接受常规心衰药物治疗（常规组）.比较2组患者治疗后生化指标、心功能及治疗转归情况.结果：CBP组治疗后血钠、血钾、血肌酐、尿素氮、B型脑钠肽水平均较常规组明显改善（P〈0.01）;心率、收缩压、舒张压、左心室射血分数、心脏指数、左心室舒张末内径及24 h尿量的改善效果也均明显优于常规组（P〈0.01）;CBP组心功能分级改善情况显著优于常规组（P〈0.01）.治疗期间病死率明显低于常规组（P〈0.01）.结论：与单独使用常规药物治疗相比,CBP能显著改善顽固性心衰患者临床生化指标,增强患者心功能,改善预后.

The effect of continuous blood purification in the treatment of refractory heart failure in 73 cases

Objective：To investigate the effects of continuous blood purification （CBP） in the treatment of refractory heart failure. Methods：One hundred and fourteen patients with refractory heart failure were divided into CBP group treated with CBP therapy （73 cases） and conventional group treated with conventional heart failure drugs（41 cases）. The biochemical index, heart function and clinical outcome in two groups were compared after treatment. Results：The levels of serum sodium, potassium, creatinine, urea nitrogen and B-type brain natriuretic peptide in CBP group were significantly better than those in conventional group（P 〈 0.01 ）. Compared with the conventional group, the levels of heart rate, systolic blood pressure, diastolic blood pressure, left ventricular ejection fraction, cardiac index, left ventricular end-diastolic diameter and 24 h urine in CBP group were significantly improved （P 〈 0.01 ）. The improvement of cardiac functional grading in CBP group was significantly better than that in conventional group（ P 〈 0.01 ）. The mortality of CBP group was significantly lower than that in conventional group during treatment （P 〈 0.01 ）. Conclusions：Compared with the conventional heart failure drugs treatment, the CBP treatment can significantly improve the biochemical markers and prognosis, enhance the heart function of patients with refractory heart failure.