尼卡地平对高血压脑出血患者血清sCysC、血肌酐、血乳酸、血钙水平的调控及急性肾损伤的预防效果  

EFFECT OF NICARDIPINE ON THE REGULATION OF SERUM SCYSC,SERUM CREATININE,BLOOD LACTIC ACID AND BLOOD CALCIUM LEVELS IN PATIENTS WITH HYPERTENSIVE INTRACEREBRAL HEMORRHAGEl AND THE PREVENTION OF ACUTE RENAL INJURY

作　　者：郑瑞娟[1] 张耀龙[1] 吴立爱 王学敏[1] 吴小康 ZHENG Ruijuan;ZHANG Yaolong;WU Liai(Emergency departmentofTangshanUnionMedicalCollegeHospital,Tangshan 063000 China)

机构地区：[1]唐山市协和医院急诊科,河北唐山063000

出　　处：《内蒙古医科大学学报》2021年第6期564-569,共6页Journal of Inner Mongolia Medical University

基　　金：河北省医学科学研究课题计划(20191632)。

摘　　要：目的:探究尼卡地平对高血压脑出血(HICH)病人血清(sCysC)、血肌酐(Scr)、血乳酸(Lac)、血钙(Ca^(2+))水平的调控及急性肾损伤(AKI)的预防效果。方法:选取我院2017-01~2018-01收治的HICH病人150例为研究对象,按照随机数字表法分为观察组与对照组,各75例。其中对照组行乌拉地尔降压治疗,观察组行尼卡地平治疗。比较两组AKI发生率及sCysC、Scr、Lac、Ca^(2+)水平差异,并分析sCysC、Scr、Lac、Ca^(2+)对AKI的预测价值。结果:治疗2周后,两组血清sCysC、Scr、Lac均呈降低趋势,Ca^(2+)水平升高,且观察组sCysC、Scr、Lac水平低于对照组(P<0.05),Ca^(2+)水平高于对照组(P<0.05)。150例HICH病人出现AKI 16例(10.67%),未发生AKI 134例(89.33%)。且观察组AKI的发生率为4.00%,低于对照组的17.33%,差异具有统计学意义(P<0.05),但两组并发症总发生率差异无统计学意义(P>0.05)。二元Logistic回归分析显示,APACHEⅡ评分、sCysC、Scr、Lac均为HICH病人AKI发生的危险因素(P<0.05),Ca^(2+)为HICH病人AKI发生的保护因素(OR=0.016,P<0.05)。ROC曲线分析显示,血清sCysC、Scr、Lac、Ca^(2+)水平对HICH病人AKI预后具有一定的价值(AUC=0.932、0.840、0.833、0.886)。结论:尼卡地平对HICH病人的治疗效果肯定,其可降低AKI发生率,改善病人预后;且sCysC、Scr、Lac、Ca^(2+)水平对HICH病人AKI发生具有一定的诊断价值。Objective:To explore the regulation of nicardipine on serum(sCysC),serum creatinine(Scr),blood lactic acid Lac(Lac),blood calcium(Ca^(2+))levels and the preventive effect of acute renal injury(AKI)in patients with hypertensive intracerebral hemorrhage(HICH).Methods:The HICH patients admitted in our hospital from January 2017~January 2018 were selected as the subjects.According to the random number table method,150 patients were divided into observation group and control group,75 cases each.The incidence of AKI and the levels of sCysC,Scr,Lac and Ca^(2+)were compared between the two groups and the predictive value of s CysC,Scr,Lac and Ca^(2+)on AKI was analyzed.Results:After 2 weeks of treatment,Both groups showed decreased serum sCysC、Scr、Lac,Ca^(2+)levels rise,the sCysC、Scr、Lac level in the observation group was lower than that in the control group(P<0.05),the Ca^(2+)level was higher than that of the control group(P<0.05).Among 150 HICH patients,AKI occurred in 16 cases(10.67%),and no AKI occurred in 134 cases(89.33%).And the incidence of AKI in the observation group was 4.00%,Less than 17.33%in the control group,difference was statistically significant(P<0.05),However,there was no significant difference in the total incidence of complications between the two groups(P>0.05).Dual Logistic regression analysis showed,APACHEⅡscore and s CysC、Scr、Lac were risk factors for AKI in patients(P<0.05),Ca^(2+)was a protective factor for AKI in HICH patients(OR=0.016,P<0.05).ROC curve analysis shows,serum sCysC、Scr、Lac、Ca^(2+)levels are valuable for AKI prognosis of HICH patients(AUC=0.932,0.840,0.833,0.886).Conclusions:The therapeutic effect of nicardipine on HICH patients is certain,which can reduce the occurrence of AKI and improve the prognosis of patients,and the sCysC、Scr、Lac、Ca^(2+)level has certain diagnostic value for the AKI occurrence of HICH patients.

关 键 词：高血压脑出血 急性肾损伤 尼卡地平 血肌酐 

分 类 号：R972.4[医药卫生—药品]