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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(P<0.05);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(P<0.05);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(P<0.05);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(P<0.05);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(P<0.05)。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。
Objective: To investigate the effect of continuous renal replacement therapy (CRRT) on serum FGF-23, BNP levels and prognosis in patients with refractory heart failure. Methods: Sixty patients with refractory heart failure in our hospital were randomly divided into control group and observation group, with 30 cases in each group. The control group was given routine treatment. The observation group was treated with CRRT on the basis of the control group. The levels of serum fibroblast growth factor 23 (FGF-23), plasma brain natriuretic peptide (BNP) and nitric oxide (NO) and left ventricular end systolic volume (LVESV) (LVESD), cardiac output (CO) and left ventricular ejection fraction (LVEF) changes. Results: The total effective rate in the observation group was higher than that in the control group (P <0.05). Compared with those before treatment, the levels of serum FGF-23 and BNP in the two groups were decreased and the observation group was lower than the control group (P <0.05). Compared with those before treatment, NO levels in both groups increased after treatment, and the difference between the two groups was statistically significant (P <0.05), and the difference was statistically significant LVESV and LVESD were lower in both groups after treatment than those in the control group, and the difference was statistically significant (P <0.05). Before treatment, both CO and LVEF Increased, and the observation group than the control group, the difference was statistically significant (P <0.05). CONCLUSIONS: Continuous renal replacement therapy (CRRT) can effectively improve the clinical efficacy of patients with refractory heart failure, reduce serum FGF-23 and BNP levels, with a good prognosis.