CVVH/CAVH与IHD治疗慢性肾功能衰竭并发充血性心力衰竭的疗效比较

沈清; 甘华; 杜晓刚; 李正荣; 陈登菊

doi:10.13406/j.cnki.cyxb.2004.01.009

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CVVH/CAVH与IHD治疗慢性肾功能衰竭并发充血性心力衰竭的疗效比较

更新时间：2024-01-17

- CVVH/CAVH与IHD治疗慢性肾功能衰竭并发充血性心力衰竭的疗效比较
- Comparison of the effects between continuous hemofiltration and intermittent hemodialysis on patients of chronic renal failure with congestive heart failure
- 重庆医科大学学报 2004年第1期页码：27-30
- 作者机构：
  
  1. 重庆医科大学临床学院肾内科
  2. 重庆医科大学临床学院肾内科,重庆,400016
- 作者简介：
- 基金信息：
- DOI：10.13406/j.cnki.cyxb.2004.01.009
  中图分类号： R541.6;R692.5
- 纸质出版日期：2004，
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[1]沈清,甘华,杜晓刚,李正荣,陈登菊.CVVH/CAVH与IHD治疗慢性肾功能衰竭并发充血性心力衰竭的疗效比较[J].重庆医科大学学报,2004(01):27-30.

SHEN Qing, et al. Comparison of the effects between continuous hemofiltration and intermittent hemodialysis on patients of chronic renal failure with congestive heart failure[J]. Journal of Chongqing Medical University, 2004,(1):27-30.
[1]沈清,甘华,杜晓刚,李正荣,陈登菊.CVVH/CAVH与IHD治疗慢性肾功能衰竭并发充血性心力衰竭的疗效比较[J].重庆医科大学学报,2004(01):27-30. DOI： 10.13406/j.cnki.cyxb.2004.01.009.

SHEN Qing, et al. Comparison of the effects between continuous hemofiltration and intermittent hemodialysis on patients of chronic renal failure with congestive heart failure[J]. Journal of Chongqing Medical University, 2004,(1):27-30. DOI： 10.13406/j.cnki.cyxb.2004.01.009.

摘要

目的 :比较连续性静脉—静脉血液滤过或连续性动脉—静脉血液滤过（CVVH/CAVH）与间歇性血液透析（IHD）治疗慢性肾功能衰竭（CRF）并发充血性心力衰竭（CHF）患者的血液动力学特点、溶质清除方面的差异

并评价它们的治疗效果

以探讨CVVH/CAVH对心脏的保护作用。方法 :12 8例次CRF并发CHF的病人

72例次接受CVVH/CAVH治疗

5 6次例接受IHD治疗。所有患者记录治疗前后超滤液量 ;观察治疗前和治疗中、治疗后患者的心率、血压、肺部体征的变化以及患者的不适反应 ;测定治疗前、后的肾功能、电解质、血 β2 -微球蛋白（β2 -MG）

血甲状旁腺值（PTH）。结果 :（1）CVVH/CAVH组超滤液量明显高于IHD组（P <0 .0 5 ） ;（2 ）IHD组低血压的发生率和不适反应评分均高于CVVH/CAVH组（P <0 .0 5 ） ;（3）CVVH/CAVH组心功能的改善情况明显好于IHD组（P <0 .0 5 ） ;④CVVH/CAVH组不仅能清除BUN、Scr

还能清除PTH和β2 -MG

治疗前后的差异有显著的意义（P <0 .0 5 ）。结论 :CVVH/CAVH具有稳定的血流动力学

对心血管系统的干扰小

病人的耐受性好

并且还能清除PTH、β2 -MG等

有助于保护和恢复心功能。

Abstract

Objective:To explore the protective effects of CVVH/CAVH on heart by comparing the behavior of blood kinetics

the difference in solute clearance

and the therapeutic efficacy between CVVH/CAVH and IHD on patients of chronic renal failure(CRF) with congestive heart failure(CHF).Methods:Employed 128 CRF cases with CHF

72 recieved CVVH/CAVH and 56 underwent IHD.In all patients

volumes of ultrafiltrate were recorded.The patients′ heart rates

blood pressure

and signs of lungs were observed

and the markers of biochemistry were detected.Results:(1)The volumes of ultrafiltrati in CVVH/CAVH were higer in IHD (P<0.05).(2)The incidence of hypotension and the score of upset response in IHD were higher in CRRT(P<0.05).(3)The heart function in CVVH/CAVH were improved tetter than in IHD.(4)CVVH/CAVH could not only remove BUN and Scr but also remove PTH and β 2-MG.Conclusion:CVVH/CAVH plays an important role in improving heart function beyond IHD.

关键词

连续性血液滤过治疗血液透析肾功能衰竭心力衰竭

Keywords

CRRTIHDRenal failureCongestive heart failure

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慢性心力衰竭患者血清瘦素水平