血管紧张素转化酶抑制剂对脓毒症患者急性肾损伤的影响  

Effect of angiotensin-converting enzyme inhibitor on acute kidney injury in patients with sepsis

作　　者：舒平[1] 熊唤宏[1] 何燕[1] 周慧云[1] 

机构地区：[1]北京大学深圳医院急诊科,广东省深圳518036

出　　处：《中华急诊医学杂志》2013年第7期779-782,共4页Chinese Journal of Emergency Medicine

摘　　要：目的探讨血管紧张素转化酶抑制剂贝那普利对脓毒症患者肾功能的影响。方法选取脓毒症患者常规组45例（A组）和干预组42例（B组，加用贝那普利），分别在第1、3、7天检测患者血清肌酐与胱抑素C和尿量，记录APACHEII评分，比较两组血清肌酐、胱抑素C和APACHEⅡ评分，并比较两组急性肾损伤的发生率和胱抑素C异常发生率。结果在第7天，B组患者在3、7天血清肌酐及胱抑素c均较A组低，B组患者的急性肾损伤发生率明显低于A组，B组患者的胱抑素C异常发生率明显低于A组，B组患者的APACHEⅡ评分亦较A组低。结论血管紧张素转换酶抑制剂贝那普利能减轻脓毒症患者急性肾损伤，并能改善病情。Objective To investigate the protective effect of angiotensin-converting enzyme inhibitor （ACEI） on kidney function in patients with sepsis. Methods Eighty-seven patients with sepsis were randomly （random number） divided into the routine treatment （A group, n =45 ） and the ACEI intervention group （ B group, n = 42）. Patients were managed by international guidelines for sepsis in A group and were treated with benazepril （ACEI） 20 mg a day in addition in B group. Serum creatinine and cystatin C were detected and APACHE lI scores and urine output were recorded on the 1st, 3rd and 7th day. Those laboratory findings and APACH lI score were compared between two groups. The incidence of acute kidney injury （AKI） and abnormal cystatin C levels were compared between two groups. Results In B group, serum creatinine and cystatin C of patients were lower compared with A group. The incidence of AKI and abnormal cystatin C and APACHE II scores were reduced in B group compared with the A group. Conclusions Benazepril improved sepsis-induced AKI and patient conditions.

关 键 词：脓毒症 急性肾损伤 血管紧张素转换酶抑制剂 APACHE lI评分 

分 类 号：R459.7[医药卫生—急诊医学]