左西孟旦联合CRRT对脓毒症休克所致急性肾损伤患者肾脏血流参数、炎症因子及康复进程的影响  

Effects of Levosimendan Combined with CRRT on Renal Blood Flow Parameters,Inflammatory Factors and Rehabilitation Process in Patients with Acute Kidney Injury Caused by Septic Shock

作　　者：高燕 罗婷 GAO Yan;LUO Ting

机构地区：[1]景德镇市第二人民医院重症医学科,江西景德镇333000

出　　处：《中国医学创新》2024年第35期1-6,共6页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202212054)。

摘　　要：目的:探究左西孟旦联合连续性肾脏替代治疗(CRRT)对脓毒症休克所致急性肾损伤(AKI)患者肾脏血流参数及炎症因子的影响。方法:采用随机数字表法将2020年2月—2024年2月在景德镇市第二人民医院接受治疗的114例脓毒症休克所致AKI患者分为研究组和对照组,各57例。对照组采用CRRT干预,研究组在对照组基础上加用左西孟旦。比较两组患者的血流动力学指标[心率(HR)、平均动脉压(MAP)、中心静脉压(CVP)]、肾脏血流参数[峰值强度(PI)、平均渡越时间(MTT)、曲线下面积(AUC)]、肾功能指标[胱抑素C(Cys C)、血肌酐(Scr)、血尿素氮(BUN)]、炎症因子[白细胞介素-6(IL-6)、白细胞介素-8(IL-8)、降钙素原(PCT)]及康复进程。结果:两组患者治疗后的血流动力学指标较治疗前均有所改善,且研究组均优于对照组,差异均有统计学意义(P<0.05);两组患者治疗后的肾脏血流参数均优于治疗前,且研究组均优于对照组,差异均有统计学意义(P<0.05);两组患者治疗后的肾功能指标、炎症因子较治疗前均有所降低,且研究组均低于对照组,差异均有统计学意义(P<0.05);研究组的CRRT持续时间、机械通气时间、ICU住院时间均短于对照组,急性生理学和慢性健康状况评价Ⅱ(APACHEⅡ)评分低于对照组,差异均有统计学意义(P<0.05)。结论:左西孟旦联合CRRT可有效改善脓毒症休克所致AKI患者的血流动力学、肾脏灌注,降低Cys C、Scr、BUN及炎症因子水平,缩短ICU住院时间,促进患者病情康复。Objective:To investigate the effects of Levosimendan combined with continuous renal replacement therapy(CRRT)on renal blood flow parameters and inflammatory factors in patients with acute kidney injury(AKI)caused by septic shock.Method:A total of 114 patients with septic shock induced AKI who received treatment in the Second People's Hospital of Jingdezhen from February 2020 to February 2024 were divided into study group and control group,57 cases each.The control group was treated with CRRT,and the study group was supplemented with Levosimendan on the basis of control group.Hemodynamic parameters[heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP)],renal blood flow parameters[peak intensity(PI),mean transit time(MTT),area under the curve(AUC)],renal function indicators[cystatin C(Cys C),serum creatinine(Scr),blood urea nitrogen(BUN)],inflammatory cytokines[interleukin-6(IL-6),interleukin-8(IL-8),procalcitonin(PCT)]and rehabilitation process were compared between the two groups.Result:The hemodynamic indexes of both groups after treatment were improved compared with those before treatment,and the study group were better than those of the control group,the differences were statistically significant(P<0.05).The renal blood flow parameters in two groups after treatment were better than those before treatment,and the study group were better than those of the control group,the differences were statistically significant(P<0.05).After treatment,renal function indexes and inflammatory factors in two groups were lower than those before treatment,and the study group were lower than those of the control group,the differences were statistically significant(P<0.05).The duration of CRRT,mechanical ventilation and ICU stay in the study group were shorter than those in the control group,and the score of acute physiology and chronic health evaluationⅡ(APACHEⅡ)was lower than that in the control group,the differences were statistically significant(P<0.05).Conclusion:Levosimendan combined with CRRT can effect

关 键 词：左西孟旦 连续性肾脏替代治疗 脓毒症休克 急性肾损伤 炎症因子 

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