乌司他丁对脓毒症急性肾损伤患者尿NGAL、KIM-1、L-FABP水平的影响  

Effect of ulinastatin on levels of NGAL,KIM-1 and L-FABP in urine of septic patients with acute kidney injury

作　　者：庞静[1] 韩林[1] 黄敏燕[1] 蒋玲玉[1] 熊滨[1] 张静[1] 莫丽[1] Pang Jing HAN Lin HUANG Min-yan JIANG Ling-yu XIONG Bin ZHANG Jing MO Li(The People＇s Hospital of Guangxi Zhuang Autonomous Region, Nanning 530021 , China)

机构地区：[1]广西壮族自治区人民医院,南宁530021

出　　处：《内科急危重症杂志》2017年第2期133-135,共3页Journal of Critical Care In Internal Medicine

摘　　要：目的:观察乌司他丁对脓毒症急性肾损伤(AKI)患者尿中性粒细胞明胶酶相关脂运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、肝型脂肪酸结合蛋白(L-FABP)水平的影响。方法:将88例脓毒症合并AKI患者随机纳入对照组(常规治疗)或观察组(常规治疗+乌司他丁),每组44例,比较2组治疗前、治疗后3、5、7 d患者尿液中NGAL、KIM-1及L-FABP水平、急性生理与慢性健康状况评分(APACHEⅡ)及肾损伤程度。结果:2组患者尿NGAL、KIM-1及L-FABP水平在治疗前、治疗后3、5 d均升高,但观察组升高幅度较对照组小;治疗7 d后,上述指标均下降且观察组比对照组下降更显著(均P<0.05);治疗后APACHEⅡ评分观察组与对照组比较,差异有统计学意义(14.93±1.08 vs 20.14±1.33,P<0.05),且观察组在治疗后5、7 d,肾损伤均有所恢复。结论:乌司他丁可降低脓毒症AKI患者尿中NGAL、KIM-1及L-FABP水平,并有助于肾脏损伤恢复。Objective：To discuss the effects of ulinastatin on the levels of neutrophil gelatinase associated lipocalin（NGAL）, kidney injury molecule-1（KIM-1） and liver fatty acid-binding protein（L-FABP） in urine of septic patients with acute kidney injury.Methods：A prospective study was performed on 88 septic patients with acute kidney injury.The patients were randomly divided into control group （conventional treatment, n=44） and observation group （conventional therapy ＋ UTI, n=44）.NGAL, KIM-1 and L-FABP levels in urine, severity of renal injury and APACHEⅡ scores in the two groups were compared before and 3, 5 and 7 days after treatment.Results：NGAL, KIM-1 and L-FABP levels were increased before and 3 and 5 days after treatment in both two groups, more significantly in the control group than in the observation group.After treatment for 7 days, NGAL, KIM-1 and L-FABP levels were reduced, more significantly in the observation group than in the control group （P〈0.05）.In addition, there was statistically significant difference in APACHEⅡ score after treatment between the observation group and control group （14.93±1.08 vs 20.14±1.33, P〈0.05）.After treatment for 5 and 7 days, the severity of renal injury eased in the observation group.Conclusion：UTI can reduce NGAL, KIM-1 and L-FABP levels in urine of septic patients with acute kidney injury and help alleviate the degree of renal damage.

关 键 词：乌司他丁 脓毒症 急性肾损伤 

分 类 号：R515.3[医药卫生—内科学]