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高渗盐溶液对急性失代偿性心力衰竭患者体重和血清肌酐的影响。

Effects of hypertonic saline solution on body weight and serum creatinine in patients with acute decompensated heart failure.

作者信息

Lafrenière Gabrielle, Béliveau Patrick, Bégin Jean-Yves, Simonyan David, Côté Sylvain, Gaudreault Valérie, Israeli Zeev, Lavi Shahar, Bagur Rodrigo

机构信息

Division of Cardiology, Department of Medicine, Centre Hospitalier Universitaire de Québec, Université Laval, Quebec City, QC G1R 2J6, Canada.

Department of Psychoeducation, Université du Québec à Trois-Rivières, Trois-Rivières, QC G9A 5H7, Canada.

出版信息

World J Cardiol. 2017 Aug 26;9(8):685-692. doi: 10.4330/wjc.v9.i8.685.

Abstract

AIM

To test the safety and effectiveness of hypertonic saline solution (HSS + F) as a strategy for weight loss and prevention of further deterioration of renal function.

METHODS

Patients admitted with acute decompensated heart failure (ADHF) who received HSS + F were included in the study. After a period of a standard ADHF treatment, our patients received an intravenous infusion of furosemide (250 mg) combined with HSS (150 mL of 3% NaCl) twice a day for a mean duration of 2.3 d. Our primary outcomes were weight loss and a change in serum creatinine per day of treatment. The parameters of the period prior to treatment with HSS + F were compared with those of the period with HSS + F.

RESULTS

A total of 47 patients were included. The mean creatinine on admission was 155 μmol/L ± 65 μmol/L, the ejection fraction was 40% ± 17%. The experimental treatment (HSS + F) resulted in greater weight loss per day of treatment than the standard treatment (-1.4 kg/d ± 1.4 kg/d -0.4 kg/d ± 1.0 kg/d, = 0.0168). Importantly, the change in creatinine was not significantly different.

CONCLUSION

This study supports the effectiveness of HSS + F on weight loss in patients with ADHF. The safety profile, particularly with regard to renal function, leads us to believe that HSS + F may be a valuable option for those patients presenting with ADHF who do not respond to conventional treatment with intravenous furosemide alone.

摘要

目的

测试高渗盐溶液(HSS + F)作为减肥及预防肾功能进一步恶化策略的安全性和有效性。

方法

纳入因急性失代偿性心力衰竭(ADHF)入院且接受HSS + F治疗的患者。在经过一段标准的ADHF治疗期后,我们的患者每天接受两次静脉输注速尿(250毫克)联合HSS(150毫升3%氯化钠),平均持续时间为2.3天。我们的主要结局指标是治疗期间每日体重减轻情况及血清肌酐变化。将使用HSS + F治疗前阶段的参数与使用HSS + F治疗阶段的参数进行比较。

结果

共纳入47例患者。入院时平均肌酐为155微摩尔/升±65微摩尔/升,射血分数为40%±17%。实验性治疗(HSS + F)导致每日治疗体重减轻幅度大于标准治疗(-1.4千克/天±1.4千克/天对-0.4千克/天±1.0千克/天,P = 0.0168)。重要的是,肌酐变化无显著差异。

结论

本研究支持HSS + F对ADHF患者减肥的有效性。其安全性,尤其是在肾功能方面,使我们相信HSS + F对于那些对单独静脉注射速尿的传统治疗无反应的ADHF患者可能是一种有价值的选择。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3eed/5583541/ac6c63a7daad/WJC-9-685-g001.jpg

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