title: [Observation and multifactor analysis of refractory medium-severe heart failure by micro-inflammation modification in uremic patients].
abstract: OBJECTIVE
  To investigate the therapeutic strategies and prognostic factors of refractory medium-severe heart failure in uremic patients.
  
  
  METHODS
  A single center, self control clinical research was conducted, and the data consisted of 30 uremic patients with refractory medium-severe heart failure undergoing maintenance hemodialysis (MHD), who received routine combined modality therapy and Xuebijing injection (to modify micro-inflammation). The systolic function of the left ventricle was compared before and after therapy. Multiple linear regression models were established to predict the improvements of systolic function of ventricle. Relationship between the accumulated dose of Xuebijing injection and changes of C-reactive protein (ΔCRP) was observed.
  
  
  RESULTS
  The values of left ventricle ejection fraction (LVEF), fractional shortening (FS), and stroke volume (SV) after therapy were improved compared with those before therapy [LVEF: 0.42±0.07 vs. 0.34±0.04, FS: (21.07±3.83)% vs. (16.33±2.43)%, SV: 66.83±7.00 ml vs. 52.20±7.62 ml, all P<0.01]. In terms of cardiac output (CO), there was no statistical difference before and after therapy (4.77±0.65 L/min vs. 4.49±0.68 L/min, P>0.05). In the multiple linear regression models of ΔLVEF, ΔFS and ΔSV, the independent variables that affect dependent variables included age, ΔCRP, changes of hemoglobin (ΔHb), accumulated dose of Xuebijing injection, changes of HCO(3)(-) (Δ HCO(3)(-)), changes of serum creatinine (ΔSCr), Hb and CRP after therapy, the factors and weights of which had slight variation on accordance with different dependent variables. There was significant positive correlation between accumulated dose of Xuebijing injection and ΔCRP (r=0.561, P=0.001).
  
  
  CONCLUSIONS
  Xuebijing injection can improve heart function in uremic patients by modifying micro-inflammation, whose accumulated dose and therapeutic effect show positive correlation. In addition the improvement of heart failure has something to do with age, ΔHb, Hb after therapy, the correction of acidosis and dialysis sufficiency.
authors.affiliation: Department of Nephrology, 474th Hospital of PLA, Urumqi 830013, Xinjiang, China.
authors.forename: Yan-bin
authors.initials: YB
authors.lastname: Wang
authors.forename: Wei
authors.initials: W
authors.lastname: Meng
authors.forename: Hui
authors.initials: H
authors.lastname: Zhang
authors.forename: Qing-hua
authors.initials: QH
authors.lastname: Zhai
authors.forename: Hua
authors.initials: H
authors.lastname: Xiang
authors.forename: Ya-ping
authors.initials: YP
authors.lastname: Zhao
authors.forename: Jing
authors.initials: J
authors.lastname: Rong
authors.forename: Shuai
authors.initials: S
authors.lastname: Chang
authors.forename: Hai-yan
authors.initials: HY
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003131:Combined Modality Therapy; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006333:Heart Failure / Q000188:drug therapy*; D006801:Humans; D007249:Inflammation; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D006435:Renal Dialysis; D013599:Systole; D014511:Uremia / Q000503:physiopathology / Q000628:therapy*; D016277:Ventricular Function, Left
chemical_list: D004365:Drugs, Chinese Herbal; C549376:Xuebijing