摘要
目的探讨采用连续血液净化辅助治疗重症肺炎并心力衰竭的效果及对炎性因子、心功能的影响。方法选取2018年10月—2019年12月收治的重症肺炎并心力衰竭124例,据治疗方法的不同分为观察组64例和对照组60例。对照组给予常规对症治疗,观察组在对照组基础上加用连续血液净化治疗。比较两组临床疗效,记录两组临床症状缓解时间差异,治疗前后两组肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、IL-8、左心室射血分数(LVEF)、心脏指数(CI)及血清脑钠肽(BNP)水平。结果观察组治疗总有效率高于对照组(P<0.05)。观察组下肢水肿消退时间、呼吸困难缓解时间、心率过快缓解时间均短于对照组(P<0.01)。治疗后,两组TNF-α、IL-6、IL-8、BNP水平均较治疗前降低,且观察组降低程度大于对照组(P<0.01)。治疗后,两组LVEF、CI较治疗前升高,且观察组升高程度均大于对照组(P<0.01)。两组均无明显不良反应发生。结论采用连续血液净化辅助治疗重症肺炎并心力衰竭患者,可极大提高临床疗效,加速缓解患者症状体征,有效降低体内炎性因子水平并改善心功能。
Objective To investigate effect of continuous blood purification(CBP)in adjunctive treatment of patients with severe pneumonia complicated by heart failure and its influence on inflammatory factors and cardiac function.Methods A total of 124 patients with severe pneumonia complicated by heart failure treated during October 2018 and December 2019 were selected and divided into observation group(n=64)and control group(n=60)according to different treatment methods.Control group was given conventional symptomatic treatment,while observation group was given continuous blood purification treatment on the basis of treatment for control group.Clinical efficacy was compared,and difference in remission time of clinical symptom were recorded,and levels of tumor necrosis factor-α(TNF-α),interleukin-6(IL-6),interleukin-8(IL-8),left ventricular ejection fraction(LVEF),cardiac index(CI)and serum brain natriuretic peptide(BNP)before and after treatment were also recorded in two groups.Results The total effective rate in observation group was higher than that in control group(P<0.05).Disappearance time of lower limb edema,relief times of dyspnea and tachycardia in observation group were shorter than those in control group(P<0.01).After treatment,levels of TNF-α,IL-6,IL-8 and BNP were significantly lower than those before treatment in two groups,and the decrease degrees in observation group were greater than those in control group(P<0.01);LVEF and CI levels were significantly higher than those before treatment in two groups,and the increase degrees in observation group were greater than those in control group(P<0.01).There was no obvious adverse reaction in two groups.Conclusion Continuous blood purification in adjunctive treatment of patients with severe pneumonia complicated by heart failure may greatly improve clinical efficacy,accelerate relief of symptoms and signs,effectively reduce levels of inflammatory factors and improve cardiac function.
作者
胡晓雷
李俊梅
李荣荣
陈晓娟
米丹丽
李建英
田艳珍
HU Xiao-lei;LI Jun-mei;LI Rong-rong;CHEN Xiao-juan;MI Dan-li;LI Jian-ying;TIAN Yan-zhen(Department of Emergency,the First Hospital Affiliated to Hebei North University,Zhangjiakou,Hebei 075000,China;the First Hospital of Zhangjiakou City,Department of Intensive Care Unit,Zhangjiakou,Hebei 075000,China;the First Hospital of Zhangjiakou City,Department of Cardiology,Zhangjiakou,Hebei 075000,China)
出处
《临床误诊误治》
CAS
2021年第4期59-63,共5页
Clinical Misdiagnosis & Mistherapy
基金
河北省医学科学研究重点课题计划(20191720)
张家口市科技计划项目(2021109D)。
