论文部分内容阅读
目的观察前列地尔治疗Ⅰ型心肾综合征临床效果。方法选择2014年6月—2015年12月诊断Ⅰ型心肾综合征患者120例,按入院的先后顺序以信封法随机分为观察组与对照组各60例。对照组患者给予规范治疗,观察组在对照组治疗基础上给予前列地尔注射液治疗。计量资料比较采用t检验,计数资料比较采用χ2检验,P<0.05表示差异有统计学意义。结果治疗后两组观察组患者血免疫比浊法检测血清肌钙蛋白I(cardiac troponin I,c Tn I)、血浆钠尿肽(brain natriuretic peptide,BNP)、胱抑素-C(cyscatin-c,Cys-c)、肌酐(serum creatine,Scr)、丙氨酰谷草转氨酶(AST)、尿蛋白与肌酐比值(albumin creatinine ratio,ACR)水平[(0.38±0.08)mg/L、(1 783.28±121.45)ng/ml、(1.09±0.25)mg/L、(137.68±12.37)μmol/L、(39.48±3.10)U/L、(0.56±0.12)]改善幅度优于对照组[(0.91±0.13)mg/L、(3 129.58±144.27)ng/ml、(1.76±0.32)mg/L、(189.48±15.28)μmol/L、(50.62±3.28)U/L、(0.98±0.17)],比较差异均有统计学意义(均P<0.05)。观察组患者血清血清肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)、C反应蛋白(C-reactive protein,CRP)、白介素-6(interleukin,IL-6)水平[(35.90±6.21)μg/L、(10.85±2.13)mg/L、(20.94±3.28)pg/ml]下降幅度高于对照组[(51.95±5.39)μg/L、(16.48±2.35)mg/L、(27.68±2.39)pg/ml],差异均有统计学意义(均P<0.05)。治疗后两组患者的二尖瓣舒张早期充盈速度/二尖瓣舒张晚期充盈速度(E/A)、二尖瓣舒张早期充盈速度/心肌舒张早期二尖瓣环根部运动速度峰值比(E/Ea)、收缩期峰值流速(peak systolic velocity,PSV)、舒张末期容积(end diastolic volume,EDV)、阻力指数[(1.87±0.23)、(5.38±1.03)、(39.04±5.64)cm/s、(15.80±1.58)cm/s、(0.54±0.03)与(1.23±0.17)、(8.67±1.46)、(35.27±3.90)cm/s、(11.32±1.59)cm/s、(0.72±0.04)]比较,差异均有统计学意义(均P<0.05)。结论前列地尔能有效改善I型心肾综合征患者的心脏功能,增加肾内血流量,保护心肾功能。
Objective To observe the clinical effect of alprostadil in the treatment of type Ⅰ heart-kidney syndrome. Methods From June 2014 to December 2015, 120 patients with type Ⅰ heart-kidney syndrome were selected and randomly divided into observation group and control group according to the sequence of admission. Patients in the control group were given standard treatment. The observation group was treated with alprostadil injection on the basis of the control group. Measurement data were compared using t test, count data were compared using χ2 test, P <0.05 said the difference was statistically significant. Results After treatment, the serum levels of cTn I, brain natriuretic peptide (BNP), cyscatin-c , Cys-c, Serum creatine (Scr), AST, albumin creatinine ratio (ACR) were significantly higher than those in control group [(0.38 ± 0.08) mg / (P0.01 ± 0.13), (121.45) ng / ml, (1.09 ± 0.25) mg / L, (137.68 ± 12.37) μmol / L, ) compared with the control group (P <0.01), (3 129.58 ± 144.27) ng / ml, (1.76 ± 0.32) mg / L, (189.48 ± 15.28) μmol / L, (50.62 ± 3.28) U / L, The differences were statistically significant (all P <0.05). Serum levels of tumor necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin 6 (IL-6) in serum of observation group [(35.90 ± 6.21 (P <0.05), and the difference was statistically significant (P <0.05). Compared with the control group, the decrease of the decrease was (51.95 ± 5.39) μg / L, (16.48 ± 2.35) mg / L, (20.64 ± 3.28) pg / ± 2.39) pg / ml], the difference was statistically significant (all P <0.05). The mitral early filling rate / mitral early filling velocity (E / A), mitral early filling velocity / early mitral annular mitral annulus velocity (E / Ea, peak systolic velocity (PSV), end diastolic volume (EDV), resistance index (1.87 ± 0.23), (5.38 ± 1.03) and (39.04 ± 5.64) cm / (1.80 ± 1.58) cm / s, (0.54 ± 0.03) vs (1.23 ± 0.17), (8.67 ± 1.46), (35.27 ± 3.90) cm / ], The differences were statistically significant (all P <0.05). Conclusion Alprostadil can effectively improve the cardiac function in patients with type I heart and kidney syndrome, increase renal blood flow and protect heart and kidney function.