晚期心力衰竭患者的和肝功能在使用HeartMate II左心室辅助装置的持续流动支持下得到改善
Stuart D Russell1, Joseph G Rogers, Carmelo A Milano
1Johns Hopkins Hospital, 600 N Wolfe Street, Baltimore, MD 21287, USA. srusse14@jhmi.edu
Circulation
|November 26, 2009
概括
持续流动的左心室辅助器件可以改善预先心力衰竭等待移植的患者的和肝功能. 这项研究发现,在6个月的时间内,脉动性降低没有有害影响,这表明,随着HeartMate II支持,器官功能得到改善.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 肝病学 肝病学是一种肝病学.
背景情况:
- 连续血液流动和脉动性降低对主要器官功能的影响仍未得到充分研究.
- 晚期心力衰竭需要机械循环支持,通常涉及左心室辅助装置 (LVAD).
研究的目的:
- 评估HeartMate II连续流动左心室辅助装置对晚期心力衰竭患者和肝功能的影响.
- 为了确定器官功能是否随着时间的推移而改善LVAD支持或如果减少脉动性导致有害影响.
主要方法:
- 在接受HeartMate II LVAD的309名晚期心力衰竭患者中评估了 (肌素,BUN) 和肝 (AST,ALT, bilirubin) 功能.
- 患者根据植入前的实验室值 (高于正常与正常) 进行分类.
- 在LVAD支持期间,随着时间的推移监测了血液化学.
主要成果:
- 在6个月内,在患有高于正常的植入前值的患者中,观察到和肝功能参数的显著改善.
- 在高于正常水平的组中,平均BUN和肌素显著下降 (分别P<0.0001和P<0.01).
- 肝酶 (AST,ALT) 和总胆红素也显示在正常以上的组显著下降 (P<0.001).
- 在LVAD支持期间,正常的移植前器官功能患者保持正常值.
结论:
- 心脏Mate II连续流动LVAD有效地改善了先进心力衰竭患者的和肝功能,这些患者需要移植.
- 在6个月的时间内,由于脉动性降低,没有观察到对器官功能的有害影响.
- 在这种患者群体中,LVAD支持为改善器官功能提供了有益的治疗选择.
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