促红细胞生成素联合前列地尔治疗急性肾损伤疗效观察  

The Protective Effects of Recombinant Human Erythropoietin Combined with Alprostadil in Treatment of Acute Kidney Injury

作　　者：刘斌[1] 李聃丹[1] 钱净[2] 杨玲[1] 于俊超[1] 姜晓岚[1] 白帆[1] 

机构地区：[1]昆明医科大学附属甘美医院血液净化中心,云南昆明650011 [2]昆明医科大学附属甘美医院医学检验中心,云南昆明650011

出　　处：《昆明医科大学学报》2014年第10期91-95,共5页Journal of Kunming Medical University

基　　金：云南省科技厅-昆明医科大学应用基础研究联合专项基金资助项目(2009CD209)

摘　　要：目的探讨促红细胞生成素(EPO)联合前列地尔治疗急性肾损伤(AKI)的疗效.方法将2009年6月至2013年10月间昆明医科大学附属甘美医院血液净化中心住院患者120例,符合AKI的AKIN诊断标准而入组.对照组30例,仅常规血液透析(HD)治疗;观察组分为:(1)联合用药组30例:在对照组基础上加用EPO3 000 U皮下注射3次/周,前列地尔20μg静脉滴注,1次/d,用药14 d;(2)EPO组30例:在对照组基础上予EPO 3 000 U皮下注射,3次/周,用药14 d;(3)前列地尔组30例:在对照组基础上予前列地尔20μg静脉滴注,1次/d,用药14 d.以上4组共观察28 d,记录每组患者尿量变化情况,分别在入组第4天、第8天、第15天送检血肌酐(Crea),尿NGAL、尿IL-18.结果 (1)与对照组相比较,联合用药组少尿期持续时间较短(5±0.8)d vs(10±2.3)d,血肌酐恢复至正常所需时间较短(10±1.1)d vs(16±2.3)d,P<0.05;尿NGAL、尿IL-18亦均存在统计学意义(P<0.05);(2)与对照组相比,前列地尔组、EPO组尿NGAL、尿IL-18在统计学意义(P<0.05);但EPO组与前列地尔组间尿NGAL、尿IL-18无统计学意义(P>0.05);(3)联合用药组与EPO组、前列地尔组比较,尿NGAL有统计学意义(P<0.05).但尿IL-18无统计学意义(P>0.05).结论 (1)EPO联合前列地尔治疗AKI,较单纯HD治疗可缩短少尿期时间和肾功能恢复所需时间,促进受损肾小管上皮细胞的增生修复,可在临床推荐;(2)在HD基础上,单独应用EPO或前列地尔疗效优于单纯应用HD治疗AKI.(3)联合应用EPO与前列地尔治疗AKI疗效优于单独应用EPO或前列地尔.Objective To investigate the protective effects of recombinant human combined with alprostadil in treatment of acute kidney injury （AKI） Methods erythropoietin （rHuEPO） A total of 120 hospitalized patients with AKI （AKIN） who meet the diagnostic criteria and classification were enrolled in this study. The enrolled patients were randomly divided into 4 groups： control group, combination group, EPO group and Alprostadil group, with 30 cases in each group. Patients in the control group were only given routine hemodialysis treatment, patients in the EPO group were treated with rHuEPO subcutaneously injection of 3 000 U tiw for 14 days, patients in the Alprostadil group were treated with alprostadil intravenous infusion of 20μg qd for 14 days, and volume in patients in each group were recorded, and the serum creatinine and urinary NGAL, IL-18 were detected on the 4th, 8th and 15th day. Results （1） The oliguria period in the combined treatment group was shorter than the control group （5±0.8） days, vs （10 ±2.3） days, with a significant difference （P〈0.05） . The serum creatinine returned to normal time in the combined treatment group was shorter than the control group （10±1.1） days, vs （16± 2.3） days, with a significant difference （P〈0.05） . The urine NGAL and IL-18 had statistically significant difference between groups （P〈0.05） （2） Compared with the control group, the urine NGAL and IL-18 had statistically significant difference with the EPO group and Alprostadil group （P〈0.05）, while the urine NGAL and IL-18 had no statistically significant difference between the EPO group an Alprostadil group. （3） The urine NGAL in combination group had statistically significant difference with the EPO group and Alprostadil group （P〈0.05）, but the urine IL-18 had no statistically significant difference （P〉0.05） Conclusions （1） For acute kidney injury patients, rHuEPO combined with prostaglandin in treatment of acute kidney injury can shorten oligur

关 键 词：急性肾损伤 促红细胞生成素 前列地尔 

分 类 号：R692.5[医药卫生—泌尿科学]