早期持续肾脏替代治疗对脓毒症急性肾损伤患者的疗效  

Effects of Early Continuous Renal Replacement Therapy in Patients with Acute Kidney Injury Induced by Sepsis

作　　者：王文杰[1] 赵子瑜 李敏[1] 孙玉寒[1] 秦秉玉[1] 阎磊[2] 邵凤民[2] WANG Wenjie;ZHAO Ziyu;LI Min;SUN Yuhan;QIN Bingyu;YAN Lei;SHAO Fengmin(Center ICU,Henan Provincial People’s Hospital,Zhengzhou 450003,China;Nephrology Department,Henan Provincial People’s Hospital,Zhengzhou 450003,China)

机构地区：[1]河南省人民医院中心ICU,河南郑州450003 [2]河南省人民医院肾内科,河南郑州450003

出　　处：《河南医学研究》2021年第10期1747-1750,共4页Henan Medical Research

基　　金：河南省医学科技攻关计划省部共建项目(SBGJ2018062)。

摘　　要：目的研究早期持续肾脏替代治疗(CRRT)对脓毒症急性肾损伤(AKI)患者的疗效。方法选取2018年3月至2020年9月河南省人民医院收治的103例脓毒症AKI患者。按治疗方式将患者分为对照组(51例)和观察组(52例)。对照组患者接受常规对症治疗,观察组患者在常规治疗的基础上接受早期CRRT。比较两组治疗前后血清肌酐(SCr)、血尿素氮(BUN)、降钙素原(PCT)、中性粒细胞百分比、白细胞(WBC)、血液肝型脂肪酸结合蛋白(sL-FABP)和尿液肝型脂肪酸结合蛋白(uL-FABP)水平。结果治疗后,两组SCr、BUN、PCT、中性粒细胞百分比、WBC、sL-FABP、uL-FABP水平低于治疗前,观察组SCr、BUN、PCT、中性粒细胞百分比、WBC、sL-FABP、uL-FABP水平低于对照组(P<0.05)。结论早期CRRT对脓毒症AKI患者有显著的疗效,能够通过减轻肾脏负担及净化血液改善肾功能,减轻炎症反应,降低AKI标志物水平。Objective To investigate the effects of early continuous renal replacement therapy(CRRT)in the patients with acute kidney injury(AKI)induced by sepsis.Methods A total of 103 patients with sepsis complicated with AKI admitted to Henan Provincial People’s Hospital from March 2018 to September 2020 were selected.The patients were divided into control group(51 cases)and observation group(52 cases)according to treatment methods.The patients in control group received conventional symptomatic treatment,while the patients in observation group received early CRRT on the basis of conventional treatment.Serum creatinine(SCr),blood urea nitrogen(BUN),procalcitonin(PCT),neutrophil percentage,white blood cell(WBC),serum liver fatty acid binding protein(sL-FABP)and urine liver fatty acid binding protein(uL-FABP)were compared between the two groups before and after treatment.Results After treatment,the levels of SCr,BUN,PCT,neutrophil percentage,WBC,sL-FABP and uL-FABP in the two groups were lower than those before treatment,and the levels of SCr,BUN,PCT,neutrophil percentage,WBC,sL-FABP and uL-FABP in observation group were lower than those in control group(P<0.05).Conclusion Early CRRT has a significant effect on patients with septic AKI,which could improve renal function,reduce inflammation and reduce the levels of AKI markers by reducing kidney burden and purifying blood.

关 键 词：脓毒症 急性肾损伤 持续肾脏替代治疗 肾功能 急性肾损伤标志物 

分 类 号：R692[医药卫生—泌尿科学]