连续肾脏替代治疗对脓毒症肾损伤患者尿肾损伤分子-1水平的影响  

Effect of continuous renal replacement therapy on urinary level of kidney injury molecule-1 in patients with sepsis-induced renal injury

作　　者：区景运[1] 张海红[1] 胡国强[2] 谭晓军[1] 

机构地区：[1]广东省开平市中心医院肾内科,广东开平529300 [2]广东省江门市中心医院肾内科,广东江门529000

出　　处：《广东医科大学学报》2017年第4期415-418,共4页Journal of Guangdong Medical University

摘　　要：目的探讨连续肾脏替代治疗(CRRT)对脓毒症伴急性肾损伤(AKI)患者尿肾损伤分子-1(KIM-1)表达的影响。方法 88例脓毒症伴AKI患者分别予以常规(常规组)和CRRT治疗(CRRT组),另取44名健康体检者作为对照组。检测血清降钙素原(PCT)、超敏C反应蛋白(hs CRP)、肌酐(SCr)及尿KIM-1水平,比较APACHEII评分和30 d病死率。结果CRRT组SCr、hs CRP、PCT、KIM-1水平在治疗后12、24、48 h均低于常规组(P<0.01)。CRRT组APACHEII评分在治疗后48 h明显下降(P<0.01),而常规组未见明显改善(P>0.05)。CRRT组30 d病死率明显低于常规组(20.45%vs 52.27%,P<0.01)。结论早期CRRT可降低尿KIM-1水平,改善脓毒症患者AKI发展进程。Objective To study the effect of continuous renal replacement therapy （CRRT） on urinary expression of kidney injury molecule -1 （KIM-1） in patients with sepsis-indued acute renal injury （AKI）. Methods Eighty-eight patients with sepsis-indued AKI were treated with conventional therapy （routine group） and CRRT （CRRT group）, and 44 healthy volunteers were chosen as control group. Serum levels of procalcitonin （PCT）, hypersensitivity C reactive protein （hsCRP）, creatinine （SCr） and urinary content of KIM-1 were detected, and APACHEII score and 30-day mortality were compared between 2 groups. Results SCr, hsCRP, PCT, and KIM-1 levels were lower in CRRT group than in routine group at 12, 24, and 48 h post-therapy （P〈0.01）. APACHEII score was significantly decreased in CRRT group （P〈0.01） but not in routine group （P〉0.05） at 48 h post-therapy. The 30-day mortality was lower in CRRT group compared with routine group （20.45% vs 52.27%, P〈0.01）. Conclusion Early CRRT can reduce the urinary KIM-1 level and improve the AKI progression of patients with sepsis.

关 键 词：肾损伤分子 持续肾脏替代治疗 脓毒症 

分 类 号：R459.5[医药卫生—治疗学]