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小剂量人心房利钠肽预防老年肺癌患者肺切除术后心肺并发症的效果。

Effects of low-dose human atrial natriuretic peptide for preventing post-operative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer.

机构信息

Department of General Thoracic Surgery, Osaka University Graduate School of Medicine, Suita-City, Osaka, Japan.

出版信息

Eur J Cardiothorac Surg. 2012 Jun;41(6):1330-4. doi: 10.1093/ejcts/ezr202. Epub 2012 Jan 18.

Abstract

OBJECTIVES

The objective of the present study was to evaluate the clinical effects of human atrial natriuretic peptide (hANP) on post-operative cardiopulmonary complications in elderly patients undergoing pulmonary resection for lung cancer.

METHODS

A retrospective study involving 44 consecutive patients aged ≥75 years who had elevated pre-operative B-type natriuretic peptide levels (≥30 pg/ml) and underwent a scheduled pulmonary resection for lung cancer in two specialized thoracic centres between April 2008 and March 2010. Results were compared between the patients who did and did not receive hANP during the perioperative period. The primary endpoint was the incidence of post-operative cardiopulmonary complications. Post-operative haemodynamics, white blood cell (WBC) counts and C-reactive protein (CRP) levels were also examined.

RESULTS

The incidence of post-operative cardiopulmonary complications was significantly lower in the hANP group than that in the control group (26 vs. 86%, P < 0.0001). Patients in the hANP group showed significantly lower WBC counts and serum CRP levels post-operatively.

CONCLUSIONS

Continuous infusion of low-dose hANP during lung cancer surgery had a prophylactic effect on post-operative cardiopulmonary complications in elderly lung cancer patients. (

TRIAL REGISTRATION NUMBER

JPRN-UMIN000003631).

摘要

目的

本研究旨在评估人心钠肽(hANP)对行肺癌肺切除术的老年患者术后心肺并发症的临床疗效。

方法

回顾性分析 2008 年 4 月至 2010 年 3 月在两个专业胸科中心接受择期肺癌肺切除术且术前 B 型利钠肽水平升高(≥30pg/ml)的 44 例连续≥75 岁患者的临床资料。比较围手术期使用和未使用 hANP 的患者的结果。主要终点是术后心肺并发症的发生率。还检查了术后血液动力学、白细胞(WBC)计数和 C 反应蛋白(CRP)水平。

结果

hANP 组术后心肺并发症的发生率明显低于对照组(26%比 86%,P<0.0001)。hANP 组术后 WBC 计数和血清 CRP 水平明显降低。

结论

肺癌手术期间持续输注低剂量 hANP 对老年肺癌患者术后心肺并发症有预防作用。(注册号:JPRN-UMIN000003631)。

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