灯盏花素联合连续性肾脏替代治疗对脓毒症急性肾损伤的疗效及肾功能恢复的影响  

Curative effect of breviscapine combined with CRRT on acute kidney injury in sepsis and the effect of renal function recovery

作　　者：周圆 杨焕 胡闪闪 ZHOU Yuan;YANG Huan;HU Shan-shan(Department of Nephrology,Bozhou People's Hospital,Bozhou Anhui 236800,China)

机构地区：[1]亳州市人民医院肾脏内科,安徽亳州236800

出　　处：《临床和实验医学杂志》2022年第22期2395-2399,共5页Journal of Clinical and Experimental Medicine

基　　金：安徽省自然科学基金(编号:19MH180923)。

摘　　要：目的探讨灯盏花素联合连续性肾脏替代治疗脓毒症急性肾损伤(AKI)的治疗效果及对肾功能恢复的影响。方法前瞻性选取2017年12月到2020年12月亳州市人民医院收治的81例脓毒症AKI患者作为研究对象,依据随机数字分组法将其分为观察组(41例)与对照组(40例)。对照组应用连续性肾脏替代疗法,观察组应用灯盏花素联合连续性肾脏替代治疗,连续治疗3 d。对比两组ICU住院时间、尿量恢复时间和心血管事件发生率,治疗前后的感染性指标、炎症因子指标[白细胞介素(IL)-6、IL-1β、肿瘤坏死因子-α(TNF-α)]以及肾功能相关指标。结果观察组患者的ICU住院时间、尿量恢复时间为(8.75±1.35)、(7.57±8.73)d,明显低于对照组[(12.28±3.76)、(11.21±13.42)d],观察组心血管事件发生率为14.63%,低于对照组(42.50%),差异均有统计学意义(P<0.05)。治疗后,两组感染性指标均显著降低,且观察组白细胞计数、中性粒细胞比率和降钙素原水平为(10.11±3.15)×109/L、(71.03±2.36)%、(0.38±0.09)ng/mL显著低于对照组[(13.36±3.45)×109/L、(76.58±3.14)%、(0.46±0.11)ng/mL],差异均有统计学意义(P<0.05)。治疗后,两组患者炎症因子水平明显降低,且观察组IL-6、IL-1β、TNF-α水平为(87.58±9.12)pg/mL、(14.59±3.24)μg/L、(45.41±8.35)pg/mL,低于对照组[(185.36±23.15)pg/mL、(24.12±3.64)μg/L、(74.06±9.24)pg/mL],差异均有统计学意义(P<0.05)。治疗后,两组患者患者肾功能相关指标均降低,且观察组血尿素氮、尿蛋白、肌酐为(7.07±1.02)mmol/L、(6.27±1.26)g/d、(49.53±2.14)μmol/L,低于对照组[(9.68±1.21)mmol/L、(10.98±2.42)g/d、(57.13±5.25)μmol/L],差异均有统计学意义(P<0.05)。结论对脓毒症AKI患者,应用灯盏花素联合连续性肾脏替代治疗,能够减少患者住院时间,减少心血管事件发生,抑制炎症因子水平,有利于肾功能的恢复,具有临床推广价值。Objective To investigate the curative effect of breviscapine combined with CRRT on acute kidney injury in sepsis and the effect of renal function recovery.Methods A total of 81 patients with acute kidney injury with sepsis admitted to Bozhou People's Hospital from December 2017 to December 2020 were retrospectively selected as the research subjects and divided into observation group(41 cases)and control group(40 cases)according to random number grouping method.The control group was treated with continuous renal replacement therapy,and the observation group was treated with Breviscapine combined with continuous renal replacement therapy,continuously for 3 days.The ICU hospitalization time,urine recovery time and cardiovascular event incidence rate of the two groups were compared;the infectious indicator,inflammatory factor indexes[interleukin(IL)-6,IL-1β,tumor necrosis factor-α(TNF-α)]and renal function related indexes before and after treatment were compared between the two groups.Results The ICU hospitalization time and urine recovery time of the observation group were(8.75±1.35)and(7.57±8.73)days,which were significantly lower than those in the control group[(12.28±3.76)and(11.21±13.42)days],the incidence of cardiovascular events in the observation group was 14.63%,which was lower than that in the control group(42.50%),the differences were statistically significant(P<0.05).After treatment,the infective indexes in both groups were significantly decreased,and the levels of white blood cell count,neutrophil ratio and procalcitonin in the observation group were(10.11±3.15)×109/L,(71.03±2.36)%,(0.38±0.09)ng/mL were significantly lower than those in the control group[(13.36±3.45)×109/L,(76.58±3.14)%,(0.46±0.11)ng/mL],the differences were statistically significant(P<0.05).After treatment,the levels of inflammatory factors in the two groups were significantly decreased,and the levels of IL-6,IL-1βand TNF-αin the observation group were(87.58±9.12)pg/mL,(14.59±3.24)μg/L,(45.41±8.35)pg/mL,which were l

关 键 词：灯盏花素片 连续性肾脏替代治疗 脓毒症 急性肾损伤 

分 类 号：R459.7[医药卫生—急诊医学] R692[医药卫生—治疗学]