前列腺素E联合连续肾替代治疗脓毒症伴急性肾损伤的临床研究  

Clinical study of Prostaglandin E combined with continuous renal replacement in the treatment of sepsis with acute kidney injury

作　　者：陈晓明 陈娟[2] 张琳 CHEN Xiaoming;CHEN Juan;ZHANG Lin(Department of Critical Care Medicine,Hefei Binhu Hospital,Anhui Province,Hefei230061,China;Department of General Internal Medicine,Eastern District of the First Affiliated Hospital of Anhui Medical University,Anhui Province,Hefei231600,China;Department of Critical Care Medicine,Hefei First People′s Hospital,Anhui Province,Hefei230060,China)

机构地区：[1]安徽省合肥市滨湖医院重症医学科,安徽合肥230061 [2]安徽医科大学第一附属医院东区普内科,安徽合肥231600 [3]安徽省合肥市第一人民医院重症医学科,安徽合肥230060

出　　处：《中国医药导报》2020年第15期63-66,83,共5页China Medical Herald

基　　金：安徽省公益性技术应用研究联动计划项目(1501LD04063)。

摘　　要：目的探讨前列腺素E联合连续肾替代治疗(CRRT)脓毒症伴急性肾损伤(AKI)的临床效果。方法选取2015年3月~2019年1月安徽省合肥市滨湖医院收治的脓毒症合并AKI患者83例,根据随机数字表法将其分为对照组(41例)和研究组(42例)。对照组给予CRRT治疗,研究组在对照组的基础上给予前列腺素E治疗,比较两组临床疗效、炎性因子、肾功能指标、临床转归情况及不良反应。结果研究组治疗7 d后临床总有效率显著高于对照组(P<0.05)。治疗前两组白细胞介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)比较,差异无统计学意义(P>0.05);与治疗前比较,两组治疗7 d后IL-6、hs-CRP、TNF-α均降低,且研究组低于对照组(P<0.05)。治疗前两组尿素氮(BUN)、血肌酐(SCr)、胱抑素(CysC)比较,差异无统计学意义(P>0.05);与治疗前比较,两组治疗7 d后BUN、SCr和CysC均升高,但研究组低于对照组(P<0.05)。研究组住院时间短于对照组(P<0.05),两组28 d内病死率及不良反应发生率比较,差异无统计学意义(P>0.05)。结论前列腺素E联合CRRT治疗脓毒症合并AKI,效果显著,可有效减轻肾损伤,改善炎性因子水平及预后,且用药安全性较好,临床应用价值较高。Objective To investigate the clinical effect of Prostaglandin E combined with continuous renal replacement therapy(CRRT)in sepsis with acute kidney injury(AKI).Methods A total of 83 patients with sepsis complicated with AKI who admitted to Hefei Binhu Hospital of Anhui Province from March 2015 to January 2019 were selected and they were divided into the control group(41 cases)and the study group(42 cases)according to the random number table method.The control group was treated with CRRT,and the study group was treated with Prostaglandin E on the basis of the control group.The clinical efficacy,inflammatory factors,kidney function indexes,clinical outcome and adverse reactions were compared between the two groups.Results The total clinical effective rate of the study group was significantly higher than that of the control group after 7 days of treatment(P<0.05).There was no statistically significant difference in interleukin-6(IL-6),tumor necrosis factor-α(TNF-α)and high-sensitivity C-reactive protein(hs-CRP)between the two groups before treatment(P>0.05).Compared with before treatment,Il-6,hs-CRP and TNF-αin the two groups decreased after 7 days of treatment,and the study group was lower than the control group(P<0.05).There was no significant difference in blood urea nitrogen(BUN),serum creatinine(SCr)and cystatin(CysC)between the two groups before treatment(P>0.05).Compared with before treatment,BUN,SCr and CysC were all increased in the two groups after 7 days of treatment,but the study group was lower than the control group(P<0.05).The length of stay in the study group was shorter than that in the control group(P<0.05),and there was no statistically significant difference in the case fatality rate and the incidence of adverse reactions between the two groups within 28 days(P>0.05).Conclusion Prostaglandin E combines with CRRT in the treatment of sepsis complicated with AKI has remarkable curative effect.It can effectively alleviate kidney injury,improve the level of inflammatory factors and prognosis,and ha

关 键 词：前列腺素E 连续肾替代治疗 脓毒症伴急性肾损伤 临床疗效 

分 类 号：R59[医药卫生—内科学]