Objective: To study the effect of Continuous Renal Replacement Therapy (CRRT) on serum BNP, IL-34, hs-CRP and blood gas analysis index in acute myocardial infarction patients with cardiac insufficiency.
Methods: 80 AMI patients who have received treatment in our hospital during the period from March, 2014 to March, 2016 were selected as our study objects. CRRT was initiated in these patients because of the failure of medical drug therapy. Blood gas analysis index, urea nitrogen, creatinine and heart rhythm index were recorded before and after CRRT and serum BNP, IL-34 and hs-CRP were measured after 12 h, 24 h and 48 h respectively.
Results: CRRT was terminated in 2 patients due to rapid decrease of thrombocyte and in other 2 patients because of viscera perfusion insufficiency, poor peripheral circulation, skin cold clammy and oliguria, additionally, their systolic pressure was less than 90 mmHg. 76 patients who could tolerate CRRT showed stable vital signs and reduced heart failure symptoms. After CRRT, serum BNP, IL-34 and hs-CRP decreased (P<0.05), urea nitrogen, creatinine, heart rate and blood gas analysis index were improved greatly (P<0.05). Four cases died of sudden cardiac death. Other 72 cases were discharged after 23-63 d and followed up for one year. All discharged patients’ NYHA grading was II and III. No deterioration of heart dysfunction was found, no long-term dialysis was required and no unstable angina and myocardial infarction appeared.
Conclusion: CRRT is a relatively safe and effective method for patients with cardiac insufficiency after AMI. It can not only stabilize internal environment, improve cardiac failure and blood gas analysis index in a short time, but also decrease serum BNP, IL-34, hs-CRP, so as to help patients pass dangerous period and improve the prognosis.
Author(s): Meina He, Xiaojun Zhao
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