连续性肾脏替代治疗对难治性心衰患者血清FGF-23和BNP水平及预后的影响

目的:探讨连续性肾脏替代治疗(CRRT)对难治性心力衰竭患者血清FGF-23、BNP水平及预后的影响。方法:选取我院明确为难治性心力衰竭患者60例,随机分为对照组和观察组,每组30例。对照组予以常规治疗,观察组在对照组基础上予以CRRT治疗。观察并比较两组患者治疗前后血清成纤维细胞生长因子23(FGF-23)、血浆脑钠肽(BNP)及一氧化氮(NO)水平,以及左心室收缩末期容积(LVESV)、左室收缩末径(LVESD)、心排血量(CO)及左心射血分数(LVEF)的变化情况。结果:观察组总有效率高于对照组,差异具有统计学意义(P0.05);与治疗前相比,两组患者治疗后血清FGF-23及BNP水平均降低,且观察组低于对照组,差异具有统计学意义(P0.05);与治疗前相比,两组患者治疗后NO水平均升高,且观察组高于对照组,差异具有统计学意义(P0.05);与治疗前相比,两组患者治疗后LVESV及LVESD均降低,且观察组低于对照组,差异具有统计学意义(P0.05);与治疗前相比,两组患者治疗后CO及LVEF均升高,且观察组高于对照组,差异具有统计学意义(P0.05)。结论:连续性肾脏替代治疗(CRRT)可有效提高难治性心力衰竭患者的临床疗效,降低血清FGF-23及BNP水平,预后良好。

Effects of Continuous Renal Replacement Therapy (CRRT) on Serum Levels of FGF-23 and BNP and Prognosis in Patients with Refractory Heart Failure

ABSTRACT Objective: To investigate the effects of continuous renal replacement therapy (CRRT) on serum levels of FGF-23 and BNP in patients with refractory heart failure and its prognostic impact. Methods: 60 patients with refractory heart failure who were treated in our hospital were selected and randomly divided into the control group and the observation group, with 30 cases in each group. The patients in the control group were treated with conventional therapy, while the patients in the observation group were treated with CRRT on the basis of the control group. Then the serum levels of fibroblast growth factor 23 (FGF-23), plasma brain natriuretic peptide (BNP) and nitric oxide (NO), the left ventricular end systolic volume (LVESV), the left ventricular end systolic diameter (LVESD), the cardiac output (CO) and the left ventricular ejection fraction (LVEF) in the two groups were observed and compared before and after the treatment. Results: The total effective rate of the observation group was higher than that of the control group, and the difference was statistically significant (P<0.05); Compared with before treatment, the serum levels of FGF-23 and BNP decreased in the two groups after the treatment, and the observation group was lower than that of the control group, and the differences were statistically significant (P<0.05); Compared with before treatment, the serum levels of NO increased in the two groups after the treatment, and the observation group was higher than that of the control group, and the differences were statistically significant (P<0.05); Compared with before treatment, the levels of CO and LVEF increased in the two groups after the treatment, and the observation group was higher than that of the control group, and the differences were statistically significant (P<0.05); Compared with before treatment, the levels of LVESV and LVESD decreased in the two groups after the treatment, and the observation group was lower than that of the control group, and the differences were statistically significant (P<0.05). Conclusion: Continuous renal replacement therapy (CRRT) can effectively improve the clinical efficacy of refractory heart failure, which can reduce the serum levels of FGF-23 and BNP, and improve the prognosis.