腹膜透析在Ⅱ型心肾综合征患者中的疗效观察-东南大学学报医学版

腹膜透析在Ⅱ型心肾综合征患者中的疗效观察

单位：1. 南京大学医学院附属鼓楼医院集团宿迁市人民医院肾内科, 江苏宿迁 223800;
2. 南京大学医学院附属鼓楼医院肾内科, 江苏南京 210008

分类号：R692.5

出版年·卷·期（页码）：2018·37·第一期（121-124）

摘要：

目的：探讨腹膜透析（PD）治疗Ⅱ型心肾综合征（CRS）患者的疗效。方法：回顾性分析我院采用PD治疗对利尿剂抵抗的24例Ⅱ型CRS患者，观察PD治疗前后患者NYHA心功能分级、血清B型尿钠肽（BNP）、心脏彩超各项参数、肾功能、电解质、血红蛋白、平均动脉压及平均每年住院率的变化。结果：24例Ⅱ型CRS患者经过PD治疗12个月后，上述各项指标均有所改善，其中血清B型尿钠肽（BNP）较治疗前显著下降（P<0.01），左室舒张末期直径（LVDd）较前显著缩小（P<0.01），左心室射血分数（LVEF）较前显著增高（P<0.01），肺动脉收缩压（PAP）较前显著下降（P<0.01），NYHA心功能分级水平显著下降（P<0.01），血肌酐较前下降（P=0.036），尿素较前显著下降（P<0.01），平均动脉压较前下降（P=0.010），平均每年住院率显著下降（P<0.01）。结论：腹膜透析（PD）能够有效改善Ⅱ型CRS患者的心功能状态及氮质血症，降低患者住院率。

Objective: To assess the efficacy of peritoneal dialysis (PD) in patients with cardiorenal syndromes. Methods: A retrospective observational study of patients with CRS Ⅱ was performe on PD, and the results were compared with those before PD. Results: Twenty four patients with CRS Ⅱwere treated with PD. Treatment with PD for 12 months was associated with significantly improved B-type natriuretic peptide (BNP) levels (P<0.01), left ventricular end diastolic diameter (LVDd) (P<0.01), left ventricular ejection fraction (LVEF) (P<0.01),pulmonary artery systolic pressure (PAP) (P<0.01), New York Heart Association (NYHA) functional status (P<0.01), serum creatine(P=0.036),blood urea nitrogen(P<0.01),systolic blood pressure (P=0.010) and the number of hospitalizations per year (P<0.01). Conclusion: PD was effective in treating patients with CRS Ⅱ, PD treatment can improve the symptoms of uremic toxin retention and cardiac function.Also can reduce the patient hospitalizations.

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