| To investigate the effect of Alprostadil on the adjuvant therapy of cardio renal syndrome in aged patient. Methods:from November 1,2013 to December 30,2014, aged patients enrolled in department of Geriatrics of our hospital, diagnosed as chronic cardio renal syndrome and the evaluation of cardiac function, patients with Ⅱ-Ⅲ heart function were selected in this study. Patients including in the study were randomly divided into the control group and the experimental group after signed an informed consent. The two groups were both excluded the causes of diseases, and interventions were introduced to these patients, including eliminated incentives, used diuretics rationally, given statins drug to patients with hypercholesterolemia, quit smoking, limited salt intake, highly quality protein low diet, protein is less than 0.6g/kg. d. In addition to the treatment of basic diseases and complications, diuretics, β receptor antagonist, ACEI or ARB treatment were given to the patients. According to the conditions of the diseases, selection the use of digitalis vasodilators, supplied with iron or injection of erythropoietin to improve anemia. Anti platelet aggregation drugs and statins were used to the coronary heart disease patients with CRS. A-keto acid is used to supply essential amino acids, and Niaoduqing as "Qing Fu Jiang Zhuo" traditional Chinese medicine is used too. The blood pressure in hypertensive patients is controlled below 130/85mmHg, blood glucose control in 5.0-7.2mmol/l and 2 hour postprandial blood glucose control below 10. Ommol/1 in diabetes patients, and pay attention to maintain electrolyte balance and other symptomatic treatment. The experimental group was given the use of Alprostadil injection based on conventional therapy (Kaishi Ted Beijing pharmaceutical Limited,2ml/10μg) lOμg in 10ml 5%g lucose solution or physiological saline water through slow intravenous injection,1 times a day,14 days per treatment period. Blood pressure and heart rate, and closely observe and record the adverse drug reaction were monitored during the treatment process. Heart and kidney function in patients of the two groups of main indexes of BNP (brain natriuretic peptide and left ventricular ejection fraction(LVEF), serum creatinine(SCr), glomerular filtration rate (GFR), cysteine protease inhibitor(CYS-C) were examined the day before treatment and the next day of the end of treatment. The statistical methods were used to evaluate the changes of main indexes of two groups of patients with heart and kidney function. Results:There is no significant statistical difference (p>0.05) in gender, age, heart function and classification data in the two study groups, and no significant difference between the two groups of patients with basic disease and the main complications (p>0.05). Main indicators of comparative treatment of heart and kidney function before the two groups (BNP,1VEF, SCr, GFR, CYS-C) also were not statistically different (p>0.05). The main index of the two groups of patients the heart and renal function were compared after treatment again, found that these indexes appear significant statistical difference (P<0.05). All subjects had no obvious adverse reaction during the treatment。Conclusion:Alprostadil injection can significantly improve the BNP, LVEF, SCr, GFR, CYS-C indexes in elderly cardiac and renal syndrome patients, and can effectively improve heart kidney function of patients. It is safe for clinical medication. In a word, Alprostadil injection on aged patients with cardiorenal syndrome is safe and effective in clinic, and is worth popularizing. |
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