Hybrid Blood Purification Therapy In Patients Of Chronic Renal Failure With Heart Failure

Objective:Through exploring the application of Hybrid blood purification therapy treatment in patients of chronic renal failure with heart failure, monitoring blood pressure, heart rate,breathing, serum creatinine(SCr), blood urea nitrogen(BUN), potassium(K+), hemoglobin(Hb) and parathyroid hormone(PTH), blood homocysteine(Hcy), type B urine sodium peptide(BNP), rapid reaction protein(CRP), left ventricular end-diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF), etc. Analysis of the changes in renal function and heart function before and after treatment,and exploring advantages of Hybrid blood purification in the treatment of patients of chronic renal failure with heart failure, to provide more effective measures for patients of chronic renal failure with heart failure.Methods:Selection 30 patients of chronic renal failure with heart failure of He Bei university affiliated hospital.Exclusion of idiopathic dilated cardiomyopathy and severe heart valve disease, severe ischemic heart disease, acute cerebrovascular disease, etc.Blood dialysis time not less than 3 months. The patients using Hybrid blood purification treatment,hemoperfusion apparatus series before dialyser, First blood perfusion combined hemodialysis treatment for 2 hours, perfusion apparatus remove blood perfusion after adsorption saturation,continue to line the blood dialysis treatment for 2 hours. Single treatment of total time 4 hours,trentment for 3 consecutive days,1 time a day,then treatment 3 times a week.Record before and after treatment of clinical indicators, including vital signs; Parathyroid hormone(PTH),blood homocysteine(Hcy), type B urine sodium peptide(BNP), quick reaction protein(CRP),and other laboratory examination; Left ventricular end-diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF) ultrasonic index, etc. The comparison of two sample mean using t test, P<0.05 was statistically significant.Results:Treatment of heart failure in patients with clinical signs and symptoms improved significantly after 3 days, suppress, shortness of breath, cannot lay down at night, lung rales and other symptoms. Treatment before and after initial treatment compared with SCr from(887.12±44.47)umol/L to(492.05±32.06) umol/L, more significant difference before and after treatment(P<0.05);BUN from tendency(45.12±11.26)mmol/L to(15.56±4.83)mmol/L,more significant difference before and after treatment(P<0.05);Serum K+ from(6.12 ±0.98)mmol/L to(4.22 ± 0.34)mmol/L, more significant differences before and after the treatment(P<0.05);heart rate from(124.79±11.23) times/min to(74.33±12.45) times/min,the more significant difference before and after treatment(P<0.05);Breathing from(26.02±5.43) times/min to(16.99±4.71) times/min, the more significant difference before and after treatment(P<0.05). 4 weeks after treatment in patients with blood pressure from(169.47±22.32) mm Hg fell to(128.42± 19.78) mm Hg, more significant difference before and after treatment(P<0.05);Hb from(78.67±6.26) g/L to(89.25±7.38) g/L, the more significant difference before and after treatment(P<0.05);BNP from(3998.09 ± 527.74) pg/m L to(417.91 ± 414.34) pg/m L,more significant difference before and after treatment(P<0.05);PTH from(785.92 ± 176.45) pg/m L to(571.12 ± 112.64) pg/m L, the more significant difference before and after treatment(P<0.05);Hcy from(54.75±6.58) umol/L to(24.45±7.37)umol/L, before and after treatment was significant difference(P<0.05);CRP from(17.09±8.65)mg/L to(3.44±2.53)mg/L, the more significant difference before and after treatment(P<0.05); LVEF from(50.21±4.33)% to(66.06±6.52)%, compared significant difference before and after treatment(P<0.05);LVEDD from(55.32±6.82) mm down to(48.54±6.58)mm, the more significant difference before and after treatment(P<0.05).Conclusions:1 Hybrid blood purification therapy can reducing load capacity and small molecules quickly in patients of chronic renal failure with heart failure.2 Hybrid blood purification therapy can effectively remove macromolecules of cardiovascular disease related toxins in patients of chronic renal failure with heart failure.3 Hybrid blood purification therapy improve the left ventricular ejection fraction, left ventricular end diastolic diameter reduced, improve heart function, relieve heart failure in patients with chronic renal failure.It is a effective treatment for chronic renal failure with heart failure.