Résumé
Objective:To explore the effect of hemodialysis and conventional treatment on the heart function of elderly patients with chronic renal heart syndrome(CRCS).Methods:Sixty elderly patients with CRCS who were admitted to Qinhuangdao Port Hospital from July 2017 to July 2018 were selected and divided into the observation group (received hemodialysis and conventional treatment) and the control group (received conventional treatment) according to the random number table method, each group with 30 patients. The levels of left ventricular end-systolic dimension (LVESD) and left ventricular end-diastolic dimension (LVEDD), left ventricular ejection fraction (LVEF) and left atrium anterior and posterior diameter (LAD) before and after treatment of two weeks were compared between two groups, the levels of N-terminal pro-B-type natriuretic peptide (NT-proBNP), blood urea nitrogen (BUN), cystatin C (CysC), creatinine (Cr) and tumor necrosis factor (TNF)-α, high sensitivity C-reactive protein (hs-CPR), interleukin 6 (IL-6) before and after treatment for two week were compared between two groups, and the safety of the two treatment methods was evaluated.Results:After treatment, the levels of LVESD, LVEDD, LAD in the observation group were lower than those in the control group: (26.13 ± 1.28) mm vs. (29.09 ± 1.26) mm, (47.58 ± 1.22) mm vs. (51.34 ± 1.49) mm, (30.02 ± 0.83) mm vs. (33.15 ± 1.02) mm, the level of LVEF in the observation group was higher than that in the control group: (39.63 ± 5.21)% vs. (35.77 ± 4.93)%, the differences were statistically significant ( P<0.05). After treatment, the levels of NT-proBNP, BUN, CysC and Cr in the observation group were lower than those in the control group: (1 089.31 ± 243.29) ng/L vs. (2 990.56 ± 531.22) ng/L, (16.08 ± 3.35) mmol/L vs.(21.93 ± 4.21) mmol/L, (0.35 ± 0.11) mg/L vs. (0.57 ± 0.18 mg/L, (251.62 ± 29.28) μmol/L vs. (290.66 ± 38.12) μmol/L, the differences were statistically significant ( P<0.05). After treatment, the levels of TNF-α, hs-CPR and IL-6 in the observation group were lower than those in the control group: (149.26 ± 19.53) μg/L vs. (182.33 ± 20.25) μg/L, (4.02 ± 1.33) mg/L vs. (5.38 ± 1.57) mg/L, (18.91 ± 3.11) μg/L vs. (22.45 ± 3.82) μg/L, the differences were statistically significant ( P<0.05). The incidence of adverse reactions during the treatment in the two groups had no significant difference ( P>0.05). Conclusions:The use of hemodialysis on the basis of conventional treatment can improve the heart and kidney function of elderly patients with CRCS, and this method is beneficial to alleviate left heart dilation and inflammation. It is a safe and effective treatment method.
Résumé
Objective To investigate the effects of astragalosides(AST)on angiogenesis of myocardium in rats after myocardial infarction.Methods Myocardial infarction(MI)was induced by ligation of the proximal left anterior descending coronary artery,30 postoperative rats were randomly divided into three same-size groups,i.e,medical group A(AST 2.5 mg · kg-1 · d-1),medical group B(AST 10mg · kg-1 · d-1)and control group(physiological saline).All of three groups were treated with intraperitoneal injection of 2ml dose for 4 weeks.The pathological changes of the heart tissue were observed by H-E staining and the micro-vascular count(MVC)/micro-vascular density (MVD)were calculated by CD34-staining.Results HE staining showed cardiac fabric disarrangement,granulation tissue generation,and fibroblast proliferation;The change of medical groups was less obvious than the control group; the change of group B with higher dose was less obvious than group A.CD34 staining showed that regeneration of neovascularization at the margin of myocaardium infarction was seen in all of three groups;for the MVC/MVD,medical groups were significantly higher than the control group,while group B is significantly higher than group A (all P ＜0.01).Conclusion AST can improve myocardial ischemia of rats after myocardial infarction.AST can promote angiogenesis in ischemic myocardium of rats,and the effect is positively correlated with AST dose.