增强型体外反搏治疗老年慢性心力衰竭合并肾功能不全病人的疗效观察

doi:10.3969/j.issn.1003-9198.2024.11.011

摘要/Abstract

摘要： 目的观察增强型体外反搏(EECP)治疗老年慢性心力衰竭(心衰)合并肾功能不全病人的疗效。方法选取90例于广西壮族自治区江滨医院住院治疗的慢性心衰合并肾功能不全病人,随机分为反搏组和对照组,每组45例,对照组给予内科常规治疗,反搏组在常规治疗的基础上加用EECP治疗。比较2组病人治疗前后N末端B型钠尿肽前体(NT-proBNP)、LVEF、NYHA心功能分级、血肌酐(Scr)、24 h尿量、最大摄氧量(VO₂max)、无氧阈(AT)以及日常生活能力(ADL)的变化。结果 2组最终均有40例病人完成治疗,治疗前2组NT-proBNP、LVEF、NYHA分级、Scr、24 h尿量、VO₂max、AT、ADL差异均无统计学意义 (P＞0. 05)。治疗18 d 后,2组NT-proBNP、NYHA分级Ⅱ级比例、Scr、24 h尿量以及反搏组VO₂max、AT均较治疗前改善,且反搏组LVEF、NYHA分级Ⅱ级比例、24 h尿量、VO₂max、AT优于对照组,差异均有统计学意义(P＜0. 05或P＜0. 01)。结论 EECP对于老年慢性心衰合并肾功能不全病人是相对低风险、无创的辅助治疗,短期可以观察到尿量增加、心功能改善等益处。

关键词: 增强型体外反搏, 老年人, 慢性心力衰竭, 肾功能不全, 心脏康复

Abstract: Objective To explore the therapeutic effect of enhanced exetrnal counterpulsation (EECP) therapy in the elderly patients with chronic heart failure and renal insufficiency. Methods A total of 90 patients with chronic heart failure and renal insufficiency who were hospitalized in Jiangbin Hospital of Guangxi Zhuang Autonomous Region were randomly divided into the counterpulsation group and the control group, with 45 patients in each group. The control group received conventional internal medicine treatment, while the counterpulsation group received EECP on the basis of conventional treatment. The levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), New York Heart Association (NYHA) cardiac function classification, serum creatinine (Scr), 24-hour urine output, maximal oxygen uptake (VO₂max), anaerobic threshold (AT) and activities of daily living (ADL) were recorded and compared between the two groups before and after treatment. Results Finally, there were 40 patients finished the treatment in each group. Before treatment, there were no significant differences in the levels of NT-proBNP, LVEF, NYHA classification, Scr, 24-hour urine output, VO₂max, AT and ADL between the two groups (P>0.05). After 18 days of treatment, the levels of NT-proBNP, NYHA classification, Scr, 24-hour urine output in the two groups and the levels of VO₂max and AT in the counterpulsation group were significantly improved than those before treatment (P＜0. 05 or P＜0. 01). And the counterpulsation group showed better results in the levels of LVEF, NYHA classification, 24-hour urine output, VO₂max and AT compared to the control group, with significant differences (P<0.05 or P＜0. 01). Conclusions EECP treatment is a relatively low-risk and non-invasive adjuvant therapy for elderly patients with chronic heart failure and renal insufficiency. It has short-term effects such as increasing urine output, improving heart function and benefiting cardiac rehabilitation.

Key words: enhanced external counterpulsation, aged, chronic heart failure, renal insufficiency, cardiac rehabilitation

中图分类号:

R 541

欧东波, 王琦, 冯光琴, 李维, 黄晓莲, 韦力. 增强型体外反搏治疗老年慢性心力衰竭合并肾功能不全病人的疗效观察[J]. 实用老年医学, 2024, 38(11): 1131-1135.

OU Dongbo, WANG Qi, FENG Guangqin, LI Wei, HUANG Xiaolian, WEI Li. Therapeutic effect of enhanced exetrnal counterpulsation therapy in elderly patients with chronic heart failure and renal insufficiency[J]. Practical Geriatrics, 2024, 38(11): 1131-1135.

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