| 摘要: |
| 目的 探讨连续性肾脏替代治疗（CRRT）在伴利尿剂抵抗的2型心肾综合征中的应用价值。方法 收集伴利尿剂抵抗的2型心肾综合征患者41例，入ICU后予CRRT治疗，观察CRRT治疗前后平均动脉压、中心静脉压、休克指数、氧合指数、尿量、血浆氨基末端B型利钠肽前体、肌酐、碳酸氢根等临床数据及血清TNF-α、IL-1β、IL-6、C反应蛋白（CRP）等炎症因子水平的变化。结果CRRT治疗后，患者中心静脉压、氧合指数、尿量、血浆氨基末端B型利钠肽前体、肌酐、碳酸氢根及炎性细胞因子TNF-α、IL-1β、IL-6水平较治疗前明显好转（均P＜0.05），而平均动脉压、休克指数、超声心动图及CRP水平均无明显变化（均P＞0.05）。结论CRRT对伴利尿剂抵抗的2型心肾综合征，尤其是重症心肾综合征患者有极大的应用价值。 |
| 关键词: 连续性肾脏替代治疗 2 型心肾综合征 利尿剂抵抗 治疗 |
| DOI： |
| 分类号: |
| 基金项目:温州市科技局基金资助项目 |
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| Continuous renal replacement therapy in treatment of type 2 cardiorenal syndrome with diuretic resistance |
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XU Jianguo, XU Min, ZHANG Xueliang, PAN Yajing
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Wenzhou People's Hospital
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| Abstract: |
| Objective The evaluate the application of continuous renal replacement therapy (CRRT) in treatment of type 2 cardiorenal syndrome with diuretic resistance. Methods Forty one patients with type 2 cardiorenal syndrome and di- uretic resistance admitted in ICU of Wenzhou People's Hospital were enrolled in this study. Patients received continuous renal re- placement therapy after admission. The mean arterial pressure, central venous pressure, shock index, oxygenation index, urine, plasma amino-terminal pro-B-type natriuretic peptide precursor, creatinine , bicarbonate and serum inflammatory cytokines TNF-α, IL-1β, IL-6, CRP in type 2 cardiorenal syndrome patients were measured before and after treatment. Results After CRRT treatment, the central venous pressure, oxygenation index, urine, plasma amino-terminal pro-B-type natriuretic peptide precursor, creatinine , bicarbonate, TNF-α, IL-1βand IL-6 were significantly improved(P＜0.05). The mean arterial blood pres- sure, shock index, echocardiography and CRP were not significantly changed (P ＞0.05). Conclusion For type 2 cardiorenal syndrome, especially critical patients with serious diuretic resistance, CRRT is of therapeutic value. |
| Key words: Continuous renal replacement therapy Type2 cardiorenal syndrome Diuretic resistance Treatment |
