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连续静脉-静脉血液滤过治疗难治性心力衰竭患者的预后危险因素。

Prognostic risk factors in patients with refractory heart failure treated with continuous veno-venous hemofiltration.

机构信息

Hemodialysis Room, The First People's Hospital of Wenling, Wenling, China.

Emergency Center, The First People's Hospital of Wenling, China.

出版信息

Ther Apher Dial. 2022 Dec;26(6):1106-1113. doi: 10.1111/1744-9987.13812. Epub 2022 Feb 22.

Abstract

INTRODUCTION

Investigation of the prognostic factors in patients with refractory heart failure (HF) undergoing continuous veno-venous hemofiltration (CVVH).

METHODS

Clinical data of 146 patients with refractory HF between May 2018 and December 2020 were retrospectively analyzed and divided into survival and death groups according to the prognosis. Vital signs, inflammatory markers, and renal function parameters were compared before and after treatment.

RESULTS

Central venous pressure levels were lower, whereas serum levels of brain natriuretic peptide, oxygen saturation, and cardiac output were higher after treatment (p < 0.05). Heart rate, systolic and diastolic blood pressures, serum levels of C-reactive protein, interleukin-6, tumor necrosis factor-α, interleukin-8, blood urea nitrogen, creatinine, and 24-h urinary protein were lower after treatment (p < 0.05).

CONCLUSION

CVVH improved renal function and regulated blood pressure and vital signs in patients with refractory HF. Age, APACHE II score, disease duration, and hypotension were risk factors affecting the prognosis.

摘要

简介

研究行连续静脉-静脉血液滤过(CVVH)的难治性心力衰竭(HF)患者的预后因素。

方法

回顾性分析 2018 年 5 月至 2020 年 12 月收治的 146 例难治性 HF 患者的临床资料,根据预后分为生存组和死亡组。比较治疗前后生命体征、炎症标志物和肾功能参数。

结果

治疗后中心静脉压水平降低,而脑钠肽、氧饱和度和心输出量的血清水平升高(p<0.05)。治疗后心率、收缩压和舒张压、C 反应蛋白、白细胞介素-6、肿瘤坏死因子-α、白细胞介素-8、血尿素氮、肌酐和 24 小时尿蛋白的血清水平降低(p<0.05)。

结论

CVVH 改善了难治性 HF 患者的肾功能,调节了血压和生命体征。年龄、APACHE II 评分、病程和低血压是影响预后的危险因素。

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