乌司他丁辅助CRRT治疗重症横纹肌溶解综合征合并急性肾损伤的临床效果观察  

Effect of CRRT combined with ulinastatin on acute renal injury in patients with severe rhabdomyolysis syndrome

作　　者：王剑[1] 周亚静[1] Wang Jian;Zhou Yajing(The People’s Hospital of Dezhou,Dezhou 253014,China)

机构地区：[1]山东省德州市人民医院,德州253014

出　　处：《广西医科大学学报》2018年第4期522-525,共4页Journal of Guangxi Medical University

摘　　要：目的:观察乌司他丁辅助连续性肾脏替代治疗(CRRT)重症横纹肌溶解综合征(RM)并发急性肾损伤(AKI)的临床效果。方法:选择2016年1月至2017年1月山东省德州市人民医院收治的40例重症RM合并AKI患者,按随机数字表法分为对照组和观察组,每组20例。两组患者均在入院后采取保肝、补液、适当氨基酸和维生素等常规治疗,对照组患者采取CRRT治疗,观察组采用乌司他丁联合CRRT进行治疗。观察两组患者横纹肌溶解释放细胞内容物、肾功能、急性生理与慢性健康评分(APACHEⅡ)及AKI敏感性标志物。结果:观察组患者治疗后尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)、肾损伤分子-1(KIM-1)、血浆尿素氮(BUN)、肌酐(Scr)、乳酸和血钾水平均较治疗前及对照组显著降低(均P<0.05),观察组治疗后1个月病死率和APACHEⅡ评分亦显著低于对照组(P<0.05)。结论:乌司他丁辅助CRRT可有效改善RM合并AKI患者的肾功能,降低病死率。Objective:To investigate the clinical effect of continuous renal replacement therapy(CRRT)combined with ulinastatin on acute renal injury(AKI)in patients with severe rhabdomyolysis syndrome.Methods:Forty severe rhabdomyolysis patients with AKI treated in our hospital from January 2016 to January 2017 were selected,and randomly divided into an observation group and a control group,with 20 cases in each group.The patients in the control group received conventional therapy and CRRT,and those in the observation group were treated as the control group with addition of ulinastatin.The neutrophil gelatinase-associated lipocalin(NGAL),kidney injury molecule-1(KIM-1),blood urea nitrogen(BUN),serum creatinine(Scr),lactic acid and serum potassium levels as well as Acute Physiology Chronic Health Evaluation(APACHE)Ⅱscore were observed and compared.Results:The NGAL,KIM-1,BUN,Scr and serum potassium levels in the observation group were significantly lower than those in the control group(P<0.05).The mortality rate after one month of treatment and APACHEⅡscore in the observation group were lower than those in the control group as well(P<0.05).Conclusion:Ulinastatin combined with CRRT therapy could improve renal function and reduce mortality in severe rhabdomyolysis patients with AKI.

关 键 词：乌司他丁 连续性肾脏替代治疗 重症横纹肌溶解综合征 急性肾损伤 

分 类 号：R685[医药卫生—骨科学] R692.5[医药卫生—外科学]